Individual
DR. JAMES DORAN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.,D.C
Contact information
Practice address
1650 LEAD HILL BLVD, SUITE 600, ROSEVILLE, CA 95661-3061
(916) 765-3785
(916) 361-9869
Mailing address
8948 SALMON FALLS DR, SACRAMENTO, CA 95826-1923
(916) 765-3785
(916) 361-9869
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
12087
CA
363AM0700X
Medical Physician Assistant
Primary
PA14039
CA
Other
Enumeration date
05/17/2007
Last updated
05/16/2009
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