Organization
TERRANCE WALLACE SC
Active
Other names
WALLACE CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRANCE MARK WALLACE DC (CHIROPRACTIC)
(715) 386-7700
Entity
Organization
Contact information
Practice address
400 2ND ST S, SUITE 265, HUDSON, WI 54016-4000
(715) 386-7700
Mailing address
400 2ND ST S, SUITE 265, HUDSON, WI 54016-4000
(715) 386-7700
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1632
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38765600
—
WI
Enumeration date
04/02/2010
Last updated
04/02/2010
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