DR. MARK ALAN WALLACE (NPI# 1942241096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942241096 |
| Entity Type | Individual |
| Full Name | DR. MARK ALAN WALLACE |
| Credential | DC |
| Practice Address |
2140 W Poplar Ave Suite 107 Collierville TN 38017-0624 |
| Practice Telephone | 9018611212 |
| Practice Fax Number | 9019611283 |
| Mailing Telephone | 9018611212 |
| Mailing Fax Number | 9018611283 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC0000002203 | TN | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 038010621 | IL | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533005 | Mark Thomas Wallace | Speech-Language Pathologist | 2337 N 2nd St, Harrisburg, PA 17110-1009 | 2015-11-21 |
| 1669467213 | Mark Spangler Wallace | Dentist | 168 N 1950 W Ste 202, Salt Lake City, UT 84116-3007 | 2005-09-20 |
| 1932104205 | Mark Randall Wallace | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259 | 2005-06-14 |
| 1760753008 | Mark Edward Wallace | Psychiatry & Neurology | 77 7th Ave, #19d, New York, NY 10011-6645 | 2012-01-18 |
| 1205110434 | Mark James Wallace | Pharmacist | 301 S Sante Fe Ave, Edmond, OK 73003 | 2011-10-06 |
| 1932367539 | Mark Richard Wallace | Chiropractor | 9337 W 75th St, Overland Park, KS 66204 | 2008-05-30 |
| 1316119548 | Mark Steven Wallace | Hearing Instrument Specialist | 202 Grand Ave, Spencer, IA 51301 | 2008-03-27 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1104047190 | Mark C Wallace | Dentist | 50 County Road B E, Saint Paul, MN 55117-1927 | 2007-05-01 |
| 1548358047 | Mark Arthur Wallace | Dentist | 1901 Research Blvd, Suite 200, Rockville, MD 20850-3164 | 2006-10-10 |
| Street Address |
2140 W POPLAR AVE SUITE 107 |
| City | COLLIERVILLE |
| State | TN |
| Zip Code | 38017-0624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922412766 | Dr Mark Wallace Pllc | Chiropractor | 2140 W Poplar Ave, Suite 107, Collierville, TN 38017-0624 | 2014-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827338 | George Nathan Freeman IIi | Chiropractor | 2028 W. Poplar, Suite 105, Collierville, TN 38017 | 2020-10-01 |
| 1104440171 | Cecelia Hunt | Social Worker | 2555 Halle Parkwsy, Collierville, TN 38017 | 2020-06-04 |
| 1053803403 | Sarah Harris | Physical Therapist | 605 Heather Lake Cv, Collierville, TN 38017 | 2018-06-01 |
| 1023507811 | Sandra P Morris | Pharmacist | 560 West Poplar, Collierville, TN 38017 | 2018-05-07 |
| 1043751159 | Rahim Panjwani | Physical Therapist | 2028 W. Poplar Ave, Collierville, TN 38017 | 2017-03-09 |
| 1104273234 | The Branch House | Counselor | 562 Center St, Collierville, TN 38017 | 2016-05-18 |
| 1760840052 | Amodeo Chiropractic Center Inc | Chiropractor | 161 Hwy 72 East, Collierville, TN 38017 | 2016-02-02 |
| 1235520628 | Bonnie Morales | Nurse Practitioner | 472 W. Poplar Ave, Collierville, TN 38017 | 2015-02-06 |
| 1841616513 | First Choice Transportation | Non-emergency Medical Transport (VAN) | 336 E. Valleywood Drive, Collierville, TN 38017 | 2014-03-05 |
| 1821424276 | Shana Cole Cannon | Licensed Practical Nurse | 777 W. Poplar Ave., Suite 104, Collierville, TN 38017 | 2013-09-17 |
| Find all providers in zip 38017 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827338 | George Nathan Freeman IIi | Chiropractor | 2028 W. Poplar, Suite 105, Collierville, TN 38017 | 2020-10-01 |
| 1609234657 | The Chiro Place of Collierville Pllc | Chiropractor | 3615 S Houston Levee Rd Ste 110, Collierville, TN 38017-9173 | 2016-02-05 |
| 1760840052 | Amodeo Chiropractic Center Inc | Chiropractor | 161 Hwy 72 East, Collierville, TN 38017 | 2016-02-02 |
| 1215375662 | Keith Alan Amodeo | Chiropractor | 777 W Poplar Ave Ste 104, Collierville, TN 38017-6500 | 2013-06-07 |
| 1750653572 | Dena Delvaron Granger | Chiropractor | 3615 S Houston Levee Rd, Collierville, TN 38017-9192 | 2012-02-09 |
| 1144559816 | Tennessee Scoliosis Center PC | Chiropractor | 622 W Poplar Ave Ste 5-800, Collierville, TN 38017-6503 | 2009-12-09 |
| 1619110657 | Lindsey Therese Denson Carr | Chiropractor | 1180 Greenview Rd, Collierville, TN 38017-1162 | 2009-04-07 |
| 1770611568 | Walter S Walker | Chiropractor | 336 Poplar View Pkwy Ste 2, Collierville, TN 38017-3436 | 2007-03-01 |
| 1528105574 | David Kellenberger | Chiropractor | 2140 W Poplar Ave Ste 107, Collierville, TN 38017 | 2007-01-31 |
| 1578570453 | Steven Ray Amodeo | Chiropractor | 777 W Poplar Ave, Suite 104, Collierville, TN 38017-2592 | 2006-08-02 |
| Find all providers in COLLIERVILLE | ||||
| City | COLLIERVILLE |
| Zip Code | 38017 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.