Wallace, Nicole Marie

Wallace, Nicole Marie is an sole proprietor health care provider with primary practice located at 913 First Colonial Rd Ste 204 , Virginia Beach VA 23454-3198. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Hospitals / Children. Other Service Providers / Specialist is her primary health care specialty. Wallace, Nicole Marie can be contacted via phone (757) 550-0725.

Contact Information

Primary practice address
913 First Colonial Rd Ste 204 Virginia Beach VA 23454-3198
Phone: (757) 550-0725
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Hospitals / Children 282NC2000X 2305203070 Virginia

Profile Details

NPI number 1609089028
LBN Legal business name Wallace, Nicole Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2007
Last updated Mar 18th, 2019 - about 5 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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