Provider Demographics
NPI:1013927276
Name:HOWARD, WALLACE A III (DC)
Entity type:Individual
Prefix:DR
First Name:WALLACE
Middle Name:A
Last Name:HOWARD
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BEAN RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564
Mailing Address - Country:US
Mailing Address - Phone:978-422-2992
Mailing Address - Fax:978-422-7922
Practice Address - Street 1:1 BEAN RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:MA
Practice Address - Zip Code:01564
Practice Address - Country:US
Practice Address - Phone:978-422-2992
Practice Address - Fax:978-422-7922
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35805OtherHARVARD PILGRIM
MA44-00319OtherUNITED HEALTH
MA290810OtherHEALTHSOURCE
MA0823931OtherUS HEALTHCARE
MA757-597OtherTUFTS
MAW20078OtherCIGNA
MA0823931OtherUS HEALTHCARE
MA757-597OtherTUFTS