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Dr. Harry L. Wallace, DC
Chiropractor in Moline, Illinois
NPI 1578523734

Harry L. Wallace is a Chiropractor based in Moline, IL. Harry L. Wallace practices in Moline, IL and has the professional credentials of DC. The NPI Number for Harry L. Wallace is 1578523734 and holds a License No. 04667 (Illinois).

The current practice location address for Harry L. Wallace is 2001 52Nd Ave, Moline, IL and can be reached out via phone at 309-764-4901.

Location: 2001 52Nd Ave, Moline, IL, 61265-6368
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578523734
Provider Name
Harry L. Wallace
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
2001 52Nd Ave, Moline, IL, 61265-6368
Phone Number
309-764-4901
Fax Number
Provider Enumeration Date
03/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
527080 01 IL MEDICARE
038003364 05 IL
323290 01 IL BLUE CROSS BLUE SHIELD IL
institution
Provider Business Practice Location Address Details
Address
2001 52Nd Ave
City
Moline
State
Illinois
Zip
61265-6368
Phone Number
309-764-4901
Fax Number
person
Provider Business Mailing Address Details
Address
2001 52Nd Ave
City
Moline
State
Illinois
Zip
61265-6368
Phone Number
309-764-4901
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
04667 (Illinois)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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