Tyrone D Wallace is a Lake City, South Carolina based male chiropractor with 30 years of experience in General Chiropractor. He completed his graduation from Sherman College Of Straight Chiropractic in 1994. He may accept the Medicare-approved amount. Patients may be billed for more than the Medicare deductible and coinsurance. Active license number of Tyrone D Wallace as General Chiropractor is 1873 in South Carolina. Tyrone D Wallace is qualified as 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.
Complete Profile:
Tyrone D Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Chiropractor
Credentials:
DC
Experience:
30+ years
Medical School Attended:
Sherman College Of Straight Chiropractic
Graduation Year:
1994
Gender:
Male
Accepts Medicare Assignment:
May Accept
Practice Address:
263 Kelley St, Ste 100, Lake City, South Carolina, 29560-2450
Phone:
843-394-8274
Fax:
843-394-1604
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
1557541224
Enrollment ID:
I20110404000657
NPI Number:
1780633420
NPI Enumeration Date:
09 May, 2006
NPI Last Update On:
07 Dec, 2016
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tyrone D Wallace are as mentioned below.
License Number
Specialization
State
Status
1873
Chiropractor
South Carolina
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Tyrone D Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
CH1873
Medicaid
South Carolina
571012172
Other
South Carolina
BC
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
263 Kelley St, Ste 100 Lake City, South Carolina
Zip:
29560-2450
Phone Number:
843-394-8274
Fax Number:
843-394-1604
Patients can reach Tyrone D Wallace at 263 Kelley St, Ste 100, Lake City, South Carolina or can call to book an appointment on 843-394-8274. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.