Timothy Mark Wallace D.C.

NPI 1063438307 - Chiropractor - 111N00000X

NPI Details
NPI 1063438307
Gender Male
Enumeration Date 07/13/2006
Last Updated 01/27/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
4357 PHELAN RD
PHELAN CA, 92371-7675, US
Phone (760) 868-4481
Fax (760) 868-1879
Business Location
4357 PHELAN RD
PHELAN CA, 92371-7675, US
Phone (760) 868-4481
Fax (760) 868-1879
Toxanomy
Taxonomy Code 111N00000X
License State California
License Number 23400
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According to our database, Dr. Timothy Mark Wallace D.C. NPI is 1063438307, taxonomy code is 111N00000X and license number is 23400, license state is located at California. Timothy Mark Wallace D.C. physically located at 4357 Phelan Rd, Phelan CA, 92371-7675. NPI Number Timothy Mark Wallace D.C. has the Individual type.

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1063438307 NPI number is provided on an as is basis without warranty of any kind. 1063438307 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy Mark Wallace D.C. are for informational purposes only.