Shanise Wallace
Shanise Wallace is a Pharmacist in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.
- Licensed in
- WI
- In the registry since
- 2020
Practice location Address checks out
3710 57th AveKenosha, WI 53144-4820
Phone: (262) 652-1474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pharmacist (primary) | Taxonomy 183500000X · Licence 17696-40 (WI) |
|---|
Record details
| NPI number | 1114552445 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 6, 2020 |
| Last updated in NPPES | March 6, 2020 |
| Certification date | March 6, 2020 |
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Stephen Tangulie Tonsong, PHARMACIST
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