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Kyle Wallace
NPI 1619781408 · on the registry since 2025 · sole proprietor
Practice
- Address
- 1927 Lincoln St
Blair, NE 68008 - Phone
- (531) 209-6113
Additional practice sites
- 10737 Brentwood Dr Apt 2b, La Vista, NE
Registry record
- Primary taxonomy
- 372600000X
372600000X
- Sex
- Male
- Record last updated
- 2025-02-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nebraska