Individual
DARRELL Y WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LIC. AC.
Contact information
Practice address
THE CONCORD CLINIC, 56 WINTHROP STREET, CONCORD, MA 01742
(617) 719-4592
Mailing address
123 BELMONT ST, BELMONT, MA 02478-3638
(617) 719-4592
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
203604
MA
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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