MEDICARE: DR. MEGAN WALLS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	828	WY

General Provider Information

NPI Number	:	1881334415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN WALLS DC

Provider Business Mailing Address
First Line	:	910 N 8TH ST W
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-2332
Country	:	US
Telephone Number	:	307-463-2770
Fax Number	:	307-463-2773

Provider Business Practice Location Address
First Line	:	910 N 8TH ST W
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-2332
Country	:	US
Telephone Number	:	307-463-2770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	07/07/2022

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