Individual
DR. JEFFREY DAVID WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
820 CHARLEVOIX DR, SUITE 210, GRAND LEDGE, MI 48837-8188
(517) 622-2273
(517) 622-2223
Mailing address
820 CHARLEVOIX DR, SUITE 210, GRAND LEDGE, MI 48837-8188
(517) 622-2273
(517) 622-2223
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008560
MI
Other
Enumeration date
10/27/2005
Last updated
07/08/2007
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