Individual
GARRETT GENE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2515 CROSBY AVE, KLAMATH FALLS, OR 97603-4553
(541) 883-2225
(541) 882-9388
Mailing address
2515 CROSBY AVE, KLAMATH FALLS, OR 97603-4553
(541) 883-2225
(541) 882-9388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6236
OR
111N00000X
Chiropractor
CH13851
FL
111N00000X
Chiropractor
PENDING
OR
Other
Enumeration date
01/05/2022
Last updated
09/07/2022
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