Individual
DR. MAURICE SHEKEIL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2645 WHISKEY RD, SUITE 109, AIKEN, SC 29803-8075
(706) 339-5205
Mailing address
2645 WHISKEY RD, SUITE 109, AIKEN, SC 29803-8075
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3402
SC
Other
Enumeration date
12/26/2008
Last updated
12/26/2008
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