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Individual

MALLORY NICOLE WALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
26300 WOODWARD AVE, ROYAL OAK, MI 48067-0917
(248) 546-2110
Mailing address
1637 HUFFMAN BLVD, FORT WAYNE, IN 46808-2203
(269) 207-9090

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08002702A
IN
111N00000X
Chiropractor
Primary
2301010995
MI

Other

Enumeration date
02/27/2013
Last updated
08/27/2021
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