Individual
DAVID G WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 W 22ND ST, SIOUX FALLS, SD 57105-1305
(605) 336-3230
Mailing address
24223 SD HIGHWAY 19, MADISON, SD 57042-7406
(605) 489-2568
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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