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Individual
DR. DAVID STUART WALLACE
Active
Individual
DR. DAVID STUART WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006811
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131625
BLUECROSS BLUESHIELD
MO
01
—
3391509
CIGNA
MO
01
—
4400088
UNITED HEALTHCARE
MO
Enumeration date
04/12/2007
Last updated
07/08/2007
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