Individual
DR. WALLACE CHRISTOPHER WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4700 HARDY ST., SUITE M, HATTIESBURG, MS 39402-1300
(601) 261-5599
(601) 261-3295
Mailing address
4700 HARDY ST., SUITE M, HATTIESBURG, MS 39402-1300
(601) 261-5599
(601) 261-3295
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
854
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114920
—
MS
01
—
106317
HEALTH PARTNERS
MS
01
—
44-32003
UNITED HEALTH CARE NUMBER
MS
01
—
4666264
AETNA
MS
Enumeration date
10/03/2006
Last updated
07/09/2007
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