Individual
WILLIAM J WALLACE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5715 N WESTERN AVE STE B, OKLAHOMA CITY, OK 73118-1239
(405) 858-2225
Mailing address
1325 N WALKER AVE APT 133, OKLAHOMA CITY, OK 73103-6412
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4369
OK
Other
Enumeration date
10/18/2019
Last updated
10/28/2021
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