Individual
CHRISTY J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3245 HOSPITAL DR, JUNEAU, AK 99801-7809
(907) 364-4458
Mailing address
3245 HOSPITAL DR, JUNEAU, AK 99801-7809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
189
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT0189
—
AK
Enumeration date
10/16/2006
Last updated
10/22/2007
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