Individual
DR. IDA SUE WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
9375 US HIGHWAY 19 N STE B, PINELLAS PARK, FL 33782-5420
(727) 577-7775
(727) 577-7776
Mailing address
9375 US HIGHWAY 19 N STE B, PINELLAS PARK, FL 33782-5420
(727) 577-7775
(727) 577-7776
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CH002614
FL
Other
Enumeration date
02/25/2008
Last updated
02/03/2011
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