DR. JEFFREY DAVID WALLACE (NPI# 1679563928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679563928 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DAVID WALLACE |
| Credential | D.C. |
| Practice Address |
820 Charlevoix Dr Suite 210 Grand Ledge MI 48837-8188 |
| Practice Telephone | 5176222273 |
| Practice Fax Number | 5176222223 |
| Mailing Telephone | 5176222273 |
| Mailing Fax Number | 5176222223 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301008560 | MI | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629089156 | Jeffrey S Wallace | Orthopaedic Surgery | 6800 Heritage Pkwy Ste 102, Rockwall, TX 75087-8746 | 2006-08-10 |
| 1821014838 | Jeffrey W Wallace | Dentist | 74 Grafton Rd, Townshend, VT 05353-0262 | 2006-07-14 |
| 1568499234 | Jeffrey A. Wallace I | Pharmacist | 5420 Lancaster Dr, Kaiser Permanente Pharmacy Administration, Brooklyn Heights, OH 44131-1832 | 2006-06-27 |
| 1548262108 | Jeffrey Leigh Wallace | Preventive Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2005-08-12 |
| 1538557012 | Jeffrey Eugene Wallace | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2015-01-06 |
| 1619392974 | Jeffrey Michael Wallace | Physician Assistant | 600 Caisson Hill Rd, Fort Riley, KS 66442-7037 | 2014-02-24 |
| 1306006796 | Jeffrey Robert Wallace | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Building B Suite 2300, Atlanta, GA 30322-1013 | 2008-06-10 |
| 1649479171 | Jeffrey W Wallace | Physician Assistant | 112 Piper Hill Dr, First Floor, Saint Peters, MO 63376-1690 | 2007-07-14 |
| 1215027990 | Jeffrey Wallace | Internal Medicine | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-10-13 |
| 1003866419 | Jeffrey Neil Wallace | Chiropractor | 330 140 Village Rd, Unit 9a, Westminster, MD 21157-6127 | 2006-05-10 |
| Street Address |
820 CHARLEVOIX DR SUITE 210 |
| City | GRAND LEDGE |
| State | MI |
| Zip Code | 48837-8188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316108848 | Complete Health Chiropractic, PC | Chiropractor | 820 Charlevoix Dr, Suite 210, Grand Ledge, MI 48837-7100 | 2008-06-18 |
| 1760661722 | Dr. Janet Sprague, D.o. PC | Family Medicine | 820 Charlevoix Dr, Suite 220, Grand Ledge, MI 48837-7100 | 2007-10-26 |
| 1154374130 | Five Cs Communication Care Plc | Audiologist-Hearing Aid Fitter | 820 Charlevoix Dr, Ste 250, Grand Ledge, MI 48837-8188 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770061715 | Taylor Rene Van Horn | Chiropractor | 229 N. Bridge St., Grand Ledge, MI 48837 | 2018-08-01 |
| 1417334947 | Julie Ann Haan | Occupational Therapist | 6672 Ambassador Ave #111, Grand Ledge, MI 48837 | 2015-05-05 |
| 1386063022 | Rochelle Ashley Hughes | Obstetrics & Gynecology | 1035 Charlevoix Dr Ste 200, Grand Ledge, MI 48837 | 2014-04-09 |
| 1912255613 | Gordon William Jacobs | Home Health Aide | 202 1/2 Bridge St, Apt 6, Grand Ledge, MI 48837 | 2012-08-28 |
| 1497901524 | Edward D. Ball D.o., P.C. | Family Medicine | 313 S. Clinton, Grand Ledge, MI 48837 | 2008-08-08 |
| 1467667790 | Orthodontic Specialists of Mid-michigan, PC | Dentist | 1040 Charlevoix Drive, Ste, C, Grand Ledge, MI 48837 | 2007-05-11 |
| 1285773226 | Meijer Inc | Durable Medical Equipment & Medical Supplies | 730 E. Saginaw Hwy, Grand Ledge, MI 48837 | 2007-02-06 |
| 1295893733 | James Anthony Voltattorni | Dentist | 312 Taylor, Grand Ledge, MI 48837 | 2006-12-05 |
| 1336224880 | Kaci Oda Chamberlin | Pharmacist | 508 S Clinton St, Grand Ledge, MI 48837 | 2006-10-25 |
| 1164525747 | Ethan H Childs | Chiropractor | 229 N Bridge St, Grand Ledge, MI 48837 | 2006-09-07 |
| Find all providers in zip 48837 | ||||
| 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 |
|---|---|---|---|---|
| 1770061715 | Taylor Rene Van Horn | Chiropractor | 229 N. Bridge St., Grand Ledge, MI 48837 | 2018-08-01 |
| 1871973461 | Timothy Edward Tarry | Chiropractor | 12671 Dundee Dr, Grand Ledge, MI 48837-8957 | 2015-06-09 |
| 1205100435 | Amber Nichole Iszler | Chiropractor | 10160 W Grand River Hwy, Grand Ledge, MI 48837-8245 | 2012-03-06 |
| 1205005865 | Andrea Lynn Herrst | Chiropractor | 221 S Bridge St Rm 3, Grand Ledge, MI 48837-1526 | 2008-02-27 |
| 1164525747 | Ethan H Childs | Chiropractor | 229 N Bridge St, Grand Ledge, MI 48837 | 2006-09-07 |
| 1619907391 | Jerome J Koroniotis | Chiropractor | 104 W Scott St, Grand Ledge, MI 48837-1563 | 2006-07-05 |
| 1922063809 | Robert John Leindecker | Chiropractor | 11653 Hartel Rd, Suite 3750, Grand Ledge, MI 48837-9190 | 2006-04-20 |
| 1265411698 | Raymond Leonard Lanjopoulos | Chiropractor | 309 E Saginaw Hwy, Grand Ledge, MI 48837-2191 | 2006-01-13 |
| 1508859877 | Chad Lake | Chiropractor | 5680 E Saginaw Hwy, Suite C, Grand Ledge, MI 48837-8102 | 2005-08-23 |
| 1144500406 | Advanced Health | Chiropractor | 12947 Townsend Dr, #412, Grand Ledge, MI 48837-8727 | 2011-08-18 |
| Find all providers in GRAND LEDGE | ||||
| City | GRAND LEDGE |
| Zip Code | 48837 |
Please comment or provide details below to improve the information on DR. JEFFREY DAVID WALLACE.
| 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.