Wallace, Daphne
Wallace, Daphne is an individual health care provider with primary practice located at 120 Oslo Cir , Birmingham AL 35211-5965. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Wallace, Daphne can be contacted via phone (205) 944-3944.Contact Information
Primary practice address
120 Oslo Cir
Birmingham AL 35211-5965
Phone: (205) 944-3944
Fax: (205) 413-4914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | PTH4642 | Alabama |
Profile Details
| NPI number | 1043312226 |
|---|---|
| LBN Legal business name | Wallace, Daphne |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Mar 6th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043312226 | NPPES |
| Alabama | Other | 51532180 | BCBS PROVIDER # FOR ARC |
| Alabama | MEDICAID | 890015770 | BCBS PROVIDER # FOR ARC |
| Alabama | Other | 515-30526 | BCBS PROVIDER # FOR ARC |
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