CRISTY L WALLACE

FORT WORTH, TX
NPI1588959522
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: TX  AP120370)
Additional Taxonomies111NN1001X Chiropractor, Nutrition
(Licence: TX  7203)
133N00000X Nutritionist
Enumeration Date2011-06-17
Last Update Date2014-08-13
Business Address
-- CRISTY L WALLACE FNP
1651 W ROSEDALE ST STE 205
FORT WORTH, TX 76104-7437
Phone number: 817-332-9966
Mailing Address
-- CRISTY L WALLACE FNP
PO BOX 961205
FORT WORTH, TX 76161-0205
Phone number: 817-740-8400