Search › Tennessee › 111N00000X
Mark Wallace, DC
NPI 1942241096 · on the registry since 2006 · sole proprietor
Practice
- Address
- 2140 W Poplar Ave
Suite 107
Collierville, TN 38017 - Phone
- (901) 861-1212
- Fax
- (901) 961-1283
- Organisation at this address
- Dr Mark Wallace Pllc
Harlan Optometry, PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Also registered as
- 111N00000X
- Licence states on file
- IL, TN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-09-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee