Individual
CHRISTINE D WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
172 2ND ST S, NAMPA, ID 83651-3708
(208) 385-3620
(208) 386-3621
Mailing address
PO BOX 1100, BOISE, ID 83701-1100
(208) 489-4690
(208) 489-4072
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
AUD-1246
ID
231H00000X
Audiologist
Primary
AUD1246
ID
237600000X
Audiologist-Hearing Aid Fitter
21617
OR
Other
Enumeration date
12/26/2008
Last updated
03/19/2018
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