Individual
DR. BRIAN WILLIAM WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
139 MORRISTOWN RD, BERNARDSVILLE, NJ 07924-2633
(908) 221-0808
Mailing address
98 SENEY DR, BERNARDSVILLE, NJ 07924-1849
(908) 221-0808
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00676500
NJ
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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