Wallace, Brook Stephen

Wallace, Brook Stephen is an individual health care provider with primary practice located at 1000 N Main St Suite 101, Fuquay Varina NC 27526-2056. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wallace, Brook Stephen can be contacted via phone (919) 577-0660.

Contact Information

Primary practice address
1000 N Main St Suite 101 Fuquay Varina NC 27526-2056
Phone: (919) 577-0660
Fax: (919) 577-2286
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2625 North Carolina

Profile Details

NPI number 1881624989
LBN Legal business name Wallace, Brook Stephen
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Jul 9th, 2007 - about 19 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 1881624989 NPPES
North Carolina Other 0836G BCBS PROVIDER NUMBER
North Carolina MEDICAID 890836G BCBS PROVIDER NUMBER

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