Wallace, Donald W

Wallace, Donald W is an sole proprietor health care provider with primary practice located at 3003 Pershing Ct Ste 101 , Decatur IL 62526-6323. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Wallace, Donald W can be contacted via phone (217) 330-9654.

Contact Information

Primary practice address
3003 Pershing Ct Ste 101 Decatur IL 62526-6323
Phone: (217) 330-9654
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 2013004501 Missouri
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 3320 Illinois

Profile Details

NPI number 1467888537
LBN Legal business name Wallace, Donald W
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2013
Last updated Jul 22nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467888537 NPPES
Missouri Other 2013004501 HEARING AID DISPENSER LICENSE
Missouri Other 3320 HEARING AID DISPENSER LICENSE

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