Wallace, James Lewis
Wallace, James Lewis is an individual health care provider with primary practice located at 1901 Brunswick Ave Suite 200, Charlotte NC 28207-2809. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Wallace, James Lewis can be contacted via phone (704) 348-4488.Contact Information
Primary practice address
1901 Brunswick Ave Suite 200
Charlotte NC 28207-2809
Phone: (704) 348-4488
Fax: (704) 348-4496
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist | 222Z00000X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist | 224P00000X |
Profile Details
| NPI number | 1396891933 |
|---|---|
| LBN Legal business name | Wallace, James Lewis |
| Credentials | CPO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2007 |
| Last updated | Jul 23rd, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396891933 | NPPES |
| North Carolina | MEDICAID | 7795261 |
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