Wallace, John

Wallace, John is an individual health care provider with primary practice located at 300 E Main St Suite 1000, Norfolk VA 23510-1753. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Wallace, John can be contacted via phone (757) 628-4347.

Contact Information

Primary practice address
300 E Main St Suite 1000 Norfolk VA 23510-1753
Phone: (757) 628-4347
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1316926066
LBN Legal business name Wallace, John
Credentials IDC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Jul 8th, 2007 - about 17 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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