Brook S. Wallace Pa

NPI 1306915731 - Chiropractor - 111N00000X

NPI Details
NPI 1306915731
Enumeration Date 11/07/2006
Last Updated 03/07/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BROOK STEPHEN BROOK
Position OWNER
Phone (919) 577-0660
Fax (919) 577-2286
Practice Location
1000 N MAIN ST
SUITE 101
FUQUAY VARINA NC, 27526-2056, US
Phone (919) 577-0660
Fax (919) 577-2286
Business Location
1000 N MAIN ST
SUITE 101
FUQUAY VARINA NC, 27526-2056, US
Phone (919) 577-0660
Fax (919) 577-2286
Toxanomy
Taxonomy Code 111N00000X
License State North Carolina
License Number 2625
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According to our database, Brook S. Wallace Pa NPI is 1306915731, taxonomy code is 111N00000X and license number is 2625, license state is located at North Carolina. Brook S. Wallace Pa physically located at 1000 N Main St, Fuquay Varina NC, 27526-2056. NPI Number 1033115704 has the healthcare provider type.

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1306915731 NPI number is provided on an as is basis without warranty of any kind. 1306915731 is maintained by the National Plan & Provider Enumeration System. The contents of Brook S. Wallace Pa are for informational purposes only.