James Lewis Wallace JR. CPO

NPI 1396891933 - Prosthetist - 224P00000X

NPI Details
NPI 1396891933
Gender Male
Enumeration Date 01/26/2007
Last Updated 07/23/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
1901 BRUNSWICK AVE
SUITE 200
CHARLOTTE NC, 28207-2809, US
Phone (704) 348-4488
Fax (704) 348-4496
Business Location
PO BOX 24905
WINSTON SALEM NC, 27114-4905, US
Phone (336) 397-2165
Fax (336) 397-2167
Toxanomy
Taxonomy Code 224P00000X
License State
License Number
Remove 1396891933 NPI Number
 

According to our database, Mr. James Lewis Wallace JR. CPO NPI is 1396891933, taxonomy code is 224P00000X James Lewis Wallace JR. CPO physically located at 1901 Brunswick Ave, Charlotte NC, 28207-2809. NPI Number James Lewis Wallace JR. CPO has the Individual type.

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1396891933 NPI number is provided on an as is basis without warranty of any kind. 1396891933 is maintained by the National Plan & Provider Enumeration System. The contents of James Lewis Wallace JR. CPO are for informational purposes only.