Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Richard Dean Wallace, LICAC

Individual provider Nutritionist · NPI 1750458402

Mr. Richard Dean Wallace, LICAC is a Nutritionist in Great Falls, Montana. Licensed in Montana. Registered with an NPI since 2006.

Licensed in
MT
In the registry since
2006
Specialties on file
3

Practice location Address checks out

914 13th Ave S
Great Falls, MT 59405
Phone: (406) 761-3767
Fax: (406) 761-3038
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X · Licence 450 (MT)
Registered Dietitian Taxonomy 133V00000X · Licence 450 (MT)
Acupuncturist Taxonomy 171100000X · Licence 162 (MT)

Record details

NPI number1750458402
Entity typeIndividual (Type 1)
GenderMale
Credentials LICAC
Sole proprietorNo
NPI enumeratedNovember 29, 2006
Last updated in NPPESSeptember 11, 2025

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