Wallace, James Lewis

Wallace, James Lewis is an individual health care provider with primary practice located at 1901 Brunswick Ave Suite 200, Charlotte NC 28207-2809. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Wallace, James Lewis can be contacted via phone (704) 348-4488.

Contact Information

Primary practice address
1901 Brunswick Ave Suite 200 Charlotte NC 28207-2809
Phone: (704) 348-4488
Fax: (704) 348-4496
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X

Profile Details

NPI number 1396891933
LBN Legal business name Wallace, James Lewis
Credentials CPO
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Jul 23rd, 2010 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1396891933 NPPES
North Carolina MEDICAID 7795261

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