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DR. DENVER R WALLACE D.C.

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1003889148

Individual Registrant:
DR. DENVER R WALLACE D.C.
Gender: M
Sole Proprietor

Location and contact information for practice:
430 SOUTH ELM STREET  BALD KNOB, AR 72010-1177 US
Tel: 501-724-5614  Fax: 501-724-5614

Contact information for business:
430 SOUTH ELM STREET P.O. BOX 1177 BALD KNOB, AR 72010-1177 US
Tel: 501-724-5614  Fax: 501-724-5614

Registration Information:
NPI: 1003889148
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
AR1319

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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