Individual
MADELINE G WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4301 W MARKHAM ST # 574, LITTLE ROCK, AR 72205-7101
(501) 526-6477
(501) 526-7977
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2189
AR
Other
Enumeration date
10/26/2024
Last updated
12/13/2024
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