Individual
DR. KRISTINE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
10153 N. HAMPTON AVENUE, SUITE 104, MESA, AZ 85209
(480) 535-5688
Mailing address
10153 N. HAMPTON AVENUE, SUITE 104, MESA, AZ 85209
(480) 535-5688
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
16-1559
AZ
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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