NPI 1750458402

Richard Dean Wallace, LICAC

Practitioner Nutritionist Great Falls, MT

Practice location

Address: 914 13th Ave South, Great Falls, MT 59405
Phone: (406) 761-3767
Fax: (406) 761-3038

Registered specialties (3)

Nutritionist Primary

Dietary & Nutritional Service Providers Taxonomy 133N00000X Licence 450 (MT)

Other Nutritionist providers in Montana →

Registered Dietitian

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 450 (MT)

Other Dietitian, Registered providers in Montana →

Acupuncturist

Other Service Providers Taxonomy 171100000X Licence 162 (MT)

Other Acupuncturist providers in Montana →

Registry record

NPI: 1750458402
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Nov 2006
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.