Individual
DR. RENEE ANN WALLESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
113 W 3RD ST, ALLIANCE, NE 69301-3301
(308) 762-9333
(308) 762-2223
Mailing address
PO BOX 1496, ANGORA, NE 69331-1496
(308) 762-9333
(308) 762-2223
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
020578261
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020578261
MUTUAL OF OMAHA
NE
01
—
232114
MIDLANDS CHOICE
NE
01
—
36634
BLUE CROSS BLUE SHIELD
NE
01
—
P00801937
RAILROAD MEDICARE PALMETTO
NE
Enumeration date
06/09/2006
Last updated
08/27/2013
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