Individual
DR. DIANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
103 MASONVILLE RD, MOUNT LAUREL, NJ 08054
(856) 494-6789
(856) 494-6777
Mailing address
103 MASONVILLE RD, MOUNT LAUREL, NJ 08054-1612
(856) 494-6789
(856) 494-6777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00536700
NJ
Other
Enumeration date
03/26/2015
Last updated
07/02/2018
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