Individual
MR. SCOTT G WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2515 CROSBY AVE, KLAMATH FALLS, OR 97603-4553
(541) 883-2225
(541) 882-9388
Mailing address
2515 CROSBY AVE, KLAMATH FALLS, OR 97603-4553
(541) 883-2225
(541) 882-9388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0700001797
OR
Other
Enumeration date
11/15/2006
Last updated
12/07/2016
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