Brian Charles Wallace
NPI #1114378759 in Mount Holly, North Carolina
Provider Information
- NPI Number
- 1114378759
- Entity Type
- Individual
- Name
- Brian Charles Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Jun 24, 2016
- Last Updated
- Jul 6, 2016
Practice Location
- Address
- 125 W CATAWBA AVE
- City
- Mount Holly
- State
- North Carolina
- ZIP Code
- 28120-1601
- Phone
- (704) 827-3014
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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