Individual
DR. KRISTIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
703 BLADEN ST, BEAUFORT, SC 29902-4915
(843) 522-1115
(843) 522-1119
Mailing address
703 BLADEN ST, BEAUFORT, SC 29902-4915
(843) 522-1115
(843) 522-1119
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2011006243
MO
111N00000X
Chiropractor
Primary
3711
SC
Other
Enumeration date
03/10/2011
Last updated
02/15/2012
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