Individual
DR. MARY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
292 STATE ROUTE 101 UNIT K2, AMHERST, NH 03031-1730
(603) 721-2162
Mailing address
6093 SABAL CREEK BLVD, PORT ORANGE, FL 32128-7139
(603) 721-2162
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
903
NH
Other
Enumeration date
08/21/2012
Last updated
08/22/2025
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