Individual
DR. COURTNEY DANIEL WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
51633 US HIGHWAY 69 N, BULLARD, TX 75757-5546
(903) 894-3176
Mailing address
51633 US HIGHWAY 69 N, BULLARD, TX 75757-5546
(903) 894-3176
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-1969833
TAX ID
TX
Enumeration date
12/04/2006
Last updated
04/05/2010
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