Individual
DR. NICOLE MANI WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
219 MAIN ST STE A, PINEVILLE, NC 28134-7528
(704) 488-1812
Mailing address
5005 CAMROSE CROSSING LN, MATTHEWS, NC 28104-6822
(704) 488-1812
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3786
NC
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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