Individual
MARISSA I WALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
530 COLLEGE PKWY, SUITE F, ANNAPOLIS, MD 21409-4614
(410) 349-2727
(410) 349-4605
Mailing address
1407 BRENWOODE RD, ANNAPOLIS, MD 21409-5494
(410) 757-3413
(410) 349-4605
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01998
MD
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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