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Organization
WALLACE FAMILY CHIROPRACTIC PA
Active
Organization
WALLACE FAMILY CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ROBERT WALLACE DC (PRESIDENT/OWNER)
(386) 469-9777
Entity
Organization
Contact information
Practice address
502 N SPRING GARDEN AVE, DELAND, FL 32720-3193
(386) 469-9777
(386) 469-9070
Mailing address
502 N SPRING GARDEN AVE, DELAND, FL 32720-3193
(386) 469-9777
(386) 469-9070
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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