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Organization

SCOTT M WALLACE LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE DIANE CHENEY (BILLING MANAGER)
(702) 474-6996
Entity
Organization

Contact information

Practice address
8960 W CHEYENNE AVE, SUITE 110, LAS VEGAS, NV 89129-8929
(702) 474-6996
(702) 655-4389
Mailing address
8960 W CHEYENNE AVE, SUITE 110, LAS VEGAS, NV 89129-8929
(702) 474-6996
(702) 655-4389

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
B383
NV

Other

Enumeration date
10/01/2008
Last updated
10/01/2008
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