Wallace Chiropractic Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WALLACE CHIROPRACTIC CLINIC LLC

Practice address

430 S Elm St
Bald Knob, AR 72010

Phone

(501) 724-5614

NPI assigned

Dec 16, 2018

Last updated

Dec 4, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Denver Wallace, D.C.NPI 1003889148

Title

Part Owner

Phone

(501) 283-0800

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Denver R Wallace, D.C.

  • Chiropractor
  • Bald Knob, AR
  • NPI 1003889148
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1407327604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "720101177",
            "telephone_number": "501-724-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S ELM ST",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "72010",
            "telephone_number": "501-724-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DENVER",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "501-283-0800",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imi Mvere
• Shelly Rutledge, PHARM.D.
• Southern Dental Group Bald Knob, PLLC
• Ladonna Sue Thompson, MSE, CCC/SLP
• Wallace Chiropractic Clinic
• Denver R Wallace, D.C.
• Taylor Wallace, DC
• Haley Owens Weaver, PHARM. D.
• Kristin Wood, APRN

• Chiropractor in Bald Knob, AR
• Providers in Bald Knob, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.