Mable Wallace

NPI 1144512757 · on the registry since 2011 · sole proprietor

Practice

Address: 20070 Ashbrook Commons Plz
Ashburn, VA 20147
Phone: (571) 223-0517
Fax: (571) 223-0542
Organisation at this address: Harris Teeter, Llc
Doran Optometry, Pllc
Tyson Urgent Care, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: Pharmacist
183500000X
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2011-05-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia