Wallace, Dustin L

Wallace, Dustin L is an individual health care provider with primary practice located at 2 Shircliff Way Ste 900 , Jacksonville FL 32204-4753. He recently has only one registered license in Pharmacy Service Providers / Pharmacy Technician, which is considered as his primary health care specialty. Wallace, Dustin L can be contacted via phone (904) 389-9744.

Contact Information

Primary practice address
2 Shircliff Way Ste 900 Jacksonville FL 32204-4753
Phone: (904) 389-9744
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacy Technician 183700000X RPT57955 Florida

Profile Details

NPI number 1326639006
LBN Legal business name Wallace, Dustin L
Credentials CPHT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2021
Last updated Jan 27th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326639006 NPPES
Florida Other RPT57955 PHARMACY TECH

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