| NPI | 1063617918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RICHARD WALLACE Business Owner Chiropractor 913-722-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 04348) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 6478) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2008-09-10 |