Individual
DIXIE SHANNON WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
360 E 1ST ST # 187, TUSTIN, CA 92780-3211
(949) 922-7568
(714) 832-7215
Mailing address
360 E 1ST ST # 187, TUSTIN, CA 92780-3211
(949) 922-7568
(714) 832-7215
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
14079
CA
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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