Individual
DR. JOHN R WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
994 W BROADWAY AVE, MUSKEGON, MI 49441-3522
(231) 755-3333
(231) 755-5891
Mailing address
994 W BROADWAY AVE, MUSKEGON, MI 49441-3522
(231) 755-3333
(231) 755-5891
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
JW004751
MI
Other
Enumeration date
07/21/2005
Last updated
11/29/2011
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