Individual
MR. DARIN WADE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1520 NORTH MAIN STREET, RUSHVILLE, IN 46173
(765) 932-5600
(765) 932-5530
Mailing address
1105 N BENJAMIN ST, RUSHVILLE, IN 46173-1356
(765) 932-5600
(765) 932-5530
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001985A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200369100A
—
IN
Enumeration date
06/07/2006
Last updated
08/15/2016
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