Individual
DR. MARK ALAN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2140 W POPLAR AVE, SUITE 107, COLLIERVILLE, TN 38017-0624
(901) 861-1212
(901) 961-1283
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
038010621
IL
111N00000X
Chiropractor
Primary
DC0000002203
TN
Other
Enumeration date
06/09/2006
Last updated
09/29/2010
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