Shane Edward Wallace, DC

NPI #1639753239 in Brooklyn, Michigan

Provider Information

NPI Number: 1639753239
Entity Type: Individual
Name: Shane Edward Wallace, DC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: DC
Enumeration Date: May 10, 2021
Last Updated: May 10, 2021

Practice Location

Address: 9909 WAMPLERS LAKE RD
City: Brooklyn
State: Michigan
ZIP Code: 49230-9503
Phone: (517) 592-8208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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