| Wallace Brain And Spine, Pllc | |
|
102 Brickerton St, Columbus, MS 39701-3608 | |
| (662) 251-2195 | |
| Not Available |
| Full Name | Wallace Brain And Spine, Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 102 Brickerton St, Columbus, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932083482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Clara B Wallace |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629795885 PECOS PAC ID: 9032566930 Enrollment ID: I20240607002747 |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace Brain And Spine, Pllc 518 Greensboro St, Starkville, MS 39759-2805 Ph: (662) 251-2195 | Wallace Brain And Spine, Pllc 102 Brickerton St, Columbus, MS 39701-3608 Ph: (662) 251-2195 |
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