| NPI | 1861677783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT G WALLACE Owner/President 541-883-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 0700001797) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2011-01-14 |