Individual
DR. JESSE BRYAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7410 BLANCO RD, SUITE 400, SAN ANTONIO, TX 78216-4363
(800) 404-6050
(210) 477-7631
Mailing address
7410 BLANCO RD, SUITE 400, SAN ANTONIO, TX 78216-4363
(800) 404-6050
(210) 477-7631
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10627
TX
Other
Enumeration date
05/30/2007
Last updated
08/21/2008
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