Wallace, Bryan Michael
Wallace, Bryan Michael is an individual health care provider with primary practice located at 1St Marine Raider Battalion Stone Bay, Camp Lejeune NC 28542. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Wallace, Bryan Michael can be contacted via phone (910) 440-2504.Contact Information
Primary practice address
1St Marine Raider Battalion Stone Bay
Camp Lejeune NC 28542
Phone: (910) 440-2504
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1336825926 |
|---|---|
| LBN Legal business name | Wallace, Bryan Michael |
| Credentials | SOIDC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2023 |
| Last updated | Jun 30th, 2023 - about last year |
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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