Wallace, Charles L
Wallace, Charles L is an individual health care provider with primary practice located at 2901 E. 20Th Suite 104 , Farmington NM 87499. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wallace, Charles L can be contacted via phone (505) 326-0241.Contact Information
Primary practice address
2901 E. 20Th Suite 104
Farmington NM 87499
Phone: (505) 326-0241
Fax: (505) 325-8356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3628 | New Mexico |
Profile Details
| NPI number | 1902140932 |
|---|---|
| LBN Legal business name | Wallace, Charles L |
| Credentials | LADAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2012 |
| Last updated | Nov 15th, 2012 - about 13 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.
Popular Providers
-
Bonham, Richard David
205 N Auburn Ave , Farmington NM 87401-8411 -
Hodgman, Susan Anne
1006 Municipal Dr , Farmington NM 87401-5442 -
Thomas-Kemp, Catherine
1313 Mission Ave. , Farmington NM 87401 -
Mascarenas, Denise
1313 Mission Avenue , Farmington NM 87401 -
John, Tina J
1615 Ojo Court , Farmington NM 87401 -
Sanchez, Mark
1001 W Broadway Ste D , Farmington NM 87401-5638 -
Schneider, Jolene M.
1313 Mission Avenue , Farmington NM 87401-5638 -
Mayo, Julie Ann
1313 Mission Avenue , Farmington NM 87401