Doctor Name: | DONALD W WALLACE |
NPI Number: | 1467888537 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2013004501 |
Business Practice Address: | 3 Mid Rivers Mall Saint Peters, MO - 633764301 |
Business Phone Number: | 6362781965 |
Business Fax Number: | 6362781043 |
Mailing Address: | 3 Mid Rivers Mall, SAINT PETERS |
State: | MO |
Postal Code: | 633764301 |
Phone Number: | 6362781965 |
Fax Number: | 6362781043 |
NPI Enumeration Date: | 09/20/2013 |
NPI Last Update Date: | 09/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 237700000X |
License Number: | 2013004501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Hearing Instrument Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |