NPI 1679730378

Duane Wallace, RPH

Practitioner Pharmacist Perham, MN

Practice location

Address: 665 3rd St SW, Perham, MN 56573-1137
Phone: (218) 346-1169
Fax: (218) 346-1279

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 114023 (MN)

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Registry record

NPI: 1679730378
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 May 2008
Record last updated: 20 May 2008

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.