Wallace Family Chiropractic PA

NPI #1538675194 in Deland, Florida

Provider Information

NPI Number: 1538675194
Entity Type: Organization
Organization Name: Wallace Family Chiropractic PA
Primary Specialty: Chiropractor
Enumeration Date: Dec 19, 2017
Last Updated: Dec 19, 2017

Practice Location

Address: 502 N SPRING GARDEN AVE
City: Deland
State: Florida
ZIP Code: 32720-3193
Phone: (386) 469-9777

Authorized Official

Name: DR. KENNETH ROBERT WALLACE, DC
Title: PRESIDENT/OWNER
Phone: (386) 469-9777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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