Individual
DR. WILLIAM T WALLICK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2717 MAIN ST, MILES CITY, MT 59301-3902
(406) 234-2807
(406) 234-8383
Mailing address
PO BOX 296, MILES CITY, MT 59301-0296
(406) 234-2807
(406) 234-8383
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
441
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40570
BLUE SHIELD
MT
Enumeration date
11/29/2006
Last updated
07/08/2007
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