Wallace, Brian Charles

Wallace, Brian Charles is an individual health care provider with primary practice located at 125 W Catawba Ave , Mount Holly NC 28120-1601. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wallace, Brian Charles can be contacted via phone (704) 827-3014.

Contact Information

Primary practice address
125 W Catawba Ave Mount Holly NC 28120-1601
Phone: (704) 827-3014
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-06531 North Carolina

Profile Details

NPI number 1114378759
LBN Legal business name Wallace, Brian Charles
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2016
Last updated Jul 6th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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