Wallace, Richard Dean

Wallace, Richard Dean is an individual health care provider with primary practice located at 914 13Th Ave South , Great Falls MT 59405. He recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered, Other Service Providers / Acupuncturist. Dietary & Nutritional Service Providers / Nutritionist is his primary health care specialty. Wallace, Richard Dean can be contacted via phone (406) 761-3767.

Contact Information

Primary practice address
914 13Th Ave South Great Falls MT 59405
Phone: (406) 761-3767
Fax: (406) 761-3038
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X 450 Montana
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 450 Montana
Other Service Providers / Acupuncturist 171100000X 162 Montana

Profile Details

NPI number 1750458402
LBN Legal business name Wallace, Richard Dean
Credentials LICAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 8th, 2007 - about 19 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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