Organization
DR MARK WALLACE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A WALLACE DC (OWNER/CHIROPRACTOR)
(901) 861-1212
Entity
Organization
Contact information
Practice address
2140 W POPLAR AVE, SUITE 107, COLLIERVILLE, TN 38017-0624
(901) 861-1212
(901) 861-1283
Mailing address
2140 W POPLAR AVE, SUITE 107, COLLIERVILLE, TN 38017-0624
(901) 861-1212
(901) 861-1283
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2203
TN
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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