Individual
MR. WALLACE DALE FOX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1400 MAIN ST UNIT 177, CLARKSVILLE, IN 47129-3108
(812) 946-2674
(844) 832-9625
Mailing address
1400 MAIN ST UNIT 177, CLARKSVILLE, IN 47129-3108
(812) 946-2674
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71007238A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71007238A
IN
Other
Enumeration date
07/04/2017
Last updated
12/19/2023
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