Individual ProviderDixie Shannon WallAcupuncturistOther Service ProvidersPractice Address360 E 1st St # 187, Tustin, CA 92780-3211(949) 922-7568PECOS EnrollmentBased on the most recent information from CMS, provider Dixie Shannon Wall does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1437449378Provider TypeIndividualFull NameWall, Dixie ShannonGenderFemaleSole ProprietorYesEnumeration Date4/12/2011Last Updated4/12/2011Contact InformationPractice LocationPractice Address360 E 1st St # 187, Tustin, CA 92780-3211Phone(949) 922-7568Fax(714) 832-7215Mailing LocationMailing Address360 E 1st St # 187, Tustin, CA 92780-3211Phone(949) 922-7568Fax(714) 832-7215Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense14079California