Wallace, Isaac Galen

Wallace, Isaac Galen is an sole proprietor health care provider with primary practice located at 3326 Chapel Dr # 230 , Durham NC 27708-9964. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Wallace, Isaac Galen can be contacted via phone (919) 251-8437.

Contact Information

Primary practice address
3326 Chapel Dr # 230 Durham NC 27708-9964
Phone: (919) 251-8437
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 9478 North Carolina

Profile Details

NPI number 1730227216
LBN Legal business name Wallace, Isaac Galen
Credentials LMBT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 2007
Last updated Jul 21st, 2019 - about 7 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 1730227216 NPPES
North Carolina Other 9478 MASSAGE LICENSE

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