Dr Mark Wallace PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2203 Issued in TN

Legal business name

DR MARK WALLACE PLLC

Practice address

2140 W Poplar Ave
Suite 107
Collierville, TN 38017-0624

Phone

(901) 861-1212

Fax

(901) 861-1283

NPI assigned

Jun 19, 2014

Last updated

Jun 19, 2014By 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

Dr. Mark A Wallace, DCNPI 1942241096

Title

Owner/Chiropractor

Phone

(901) 861-1212

Specialties & licenses 1

Addresses

Locations

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.

• Mark Alan Wallace, DC

  • Chiropractor
  • Collierville, TN
  • NPI 1942241096
  Authorized official Same address or phone

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1922412766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W POPLAR AVE",
            "address_2": "SUITE 107",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170624",
            "telephone_number": "901-861-1212",
            "fax_number": "901-861-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W POPLAR AVE",
            "address_2": "SUITE 107",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170624",
            "telephone_number": "901-861-1212",
            "fax_number": "901-861-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK WALLACE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "901-861-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Alexander Diloreto
• Jeffrey A Dlabach, M.D.
• Nicole D Dotson
• Mia Star Douglas
• Dr Mark Lynn & Associates PLLC (Visionworks Doctors of Optometry)
• Dr Ted S Cooper Optometry LLC
• Alexandra K Drake, PMHNP
• Harmony Draper
• Ritika Dubey
• Michael Wesley Duckworth, PT

• Chiropractor in Collierville, TN
• Providers in Collierville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.