NPI 1326639006

Dustin L Wallace, CPHT

Practitioner Pharmacy Technician Jacksonville, FL

Practice location

Address: 2 Shircliff Way STE 900, Jacksonville, FL 32204-4753
Phone: (904) 389-9744
Mailing address: 2952 Rosselle St, Jacksonville, FL 32205-5666

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence RPT57955 (FL)

Other Pharmacy Technician providers in Florida →

Registry record

NPI: 1326639006
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jan 2021
Record last updated: 27 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.