Individual
DR. JAMES THOMAS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1190 CROSS ST SE, SALEM, OR 97302-2924
(503) 581-1801
(503) 485-4320
Mailing address
1190 CROSS ST SE, SALEM, OR 97302-2924
(503) 581-1801
(503) 485-4320
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3044
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500632532
—
OR
Enumeration date
10/14/2006
Last updated
07/18/2017
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