BROOK S. WALLACE PA (NPI# 1306915731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306915731 |
Entity Type | Organization |
Organization Name | BROOK S. WALLACE PA |
Other Organization Name | CHIROPRACTIC PARTNERS |
Practice Address |
1000 N Main St Suite 101 Fuquay Varina NC 27526-2056 |
Practice Telephone | 9195770660 |
Practice Fax Number | 9195772286 |
Mailing Telephone | 9195770660 |
Mailing Fax Number | 9195772286 |
Enumeration Date | 2006-11-07 |
Last Update Date | 2008-03-07 |
Authorized Official Name | DR. BROOK STEPHEN WALLACE (OWNER) |
Authorized Official Telephone | 9195770660 |
Authorized Official Credential | D.C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2625 | NC | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 890836G | 05 | |
NC | BCBS # | 0836G | 01 |
NC | ACN # | 612942 | 01 |
Other Name | Type Code |
---|---|
Chiropractic Partners | Doing Business As Name - Organization |
Street Address |
1000 N MAIN ST SUITE 101 |
City | FUQUAY VARINA |
State | NC |
Zip Code | 27526-2056 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780686014 | Kenneth William Roach | Ophthalmology | 1000 N Main St, Suite #204, Fuquay Varina, NC 27526-2056 | 2005-05-31 |
1992108203 | At Home Senior Services | In Home Supportive Care | 1000 N Main St, Suite 219, Fuquay Varina, NC 27526-2056 | 2014-09-30 |
1205978061 | Michaele Lynn Worrix | Counselor | 1000 N Main St, Suite 202, Fuquay Varina, NC 27526-2056 | 2007-02-12 |
1881624989 | Brook Stephen Wallace | Chiropractor | 1000 N Main St, Suite 101, Fuquay Varina, NC 27526-2056 | 2006-07-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336782721 | Leah C. Mcconkey | Speech-Language Pathologist | 305 Willow Grace Lane, Fuquay Varina, NC 27526 | 2019-10-18 |
1437617727 | Katherine Venable | Physician Assistant | 1418 N Main Street, Fuquay - Vanna, NC 27526 | 2019-03-06 |
1114403599 | Christine Newkirk | Social Worker | 344 Edgecroft Way, Fuquay Varina, NC 27526 | 2018-07-18 |
1851800536 | Pamela Trapp Johnson | Specialist | 196 Knight Estates Cir, Fuquay Varina, NC 27526 | 2017-09-25 |
1376908228 | Carrie Adeline Mitchell | Social Worker | 441 Leyland Cypress Ln, Fuquay Varina, NC 27526 | 2015-12-19 |
1235504267 | Keyana Sharlene Williams | Counselor | 602 E Academy St #205, Fuquay Varina, NC 27526 | 2015-12-02 |
1124452974 | Q1consultants, LLC | Community/Behavioral Health | 326 Daywood Creek Place, Fuquay, NC 27526 | 2013-08-29 |
1053759654 | Ellen Marie Macri | Developmental Therapist | 119 South Fuquay Avenue, Fuquay-varina, NC 27526 | 2013-06-05 |
1811239726 | Leslie H Yuan Gazdeck | Dentist | 1625 N Main St Ste 201, Fuquay Varina, NC 27526 | 2013-03-19 |
1093017725 | Joanne Scannell | Occupational Therapist | 119 South Fuquay Ave, Fuquay Varina, NC 27526 | 2010-12-01 |
Find all providers in zip 27526 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174933055 | Brooke Breitbach | Chiropractor | 1501 Lakestone Village Ln Ste 105, Fuquay Varina, NC 27526-4449 | 2014-05-01 |
1902153802 | David Knox | Chiropractor | 419 Stranraer Ct, Fuquay Varina, NC 27526-6988 | 2012-08-09 |
1366427544 | James Price Roper | Chiropractor | 137 N Main St, Fuquay Varina, NC 27526-1933 | 2005-12-12 |
1285256651 | Power Chiropractic Pllc | Chiropractor | 1372 N Main St, Fuquay Varina, NC 27526-2617 | 2020-05-08 |
1841858206 | Shelby Woodbury | Chiropractor | 1372 N Main St, Fuquay Varina, NC 27526-2617 | 2019-05-31 |
1689113557 | Alexander Bringmann | Chiropractor | 1501 Lakestone Village Ln Ste 105, Fuquay Varina, NC 27526-4449 | 2017-02-13 |
1487063301 | Brookview Wellness | Chiropractor | 137 N Main St, Fuquay Varina, NC 27526-1933 | 2014-08-05 |
1346315603 | Fuquay Chiropractic and Wellness Center | Chiropractor | 1420 N Main St, Fuquay Varina, NC 27526-7226 | 2006-11-22 |
1992875298 | Baird Chiropractic Inc | Chiropractor | 320 N Judd Pkwy Ne, Ste 102, Fuquay Varina, NC 27526-2624 | 2006-11-08 |
1881624989 | Brook Stephen Wallace | Chiropractor | 1000 N Main St, Suite 101, Fuquay Varina, NC 27526-2056 | 2006-07-04 |
Find all providers in FUQUAY VARINA |
City | FUQUAY VARINA |
Zip Code | 27526 |
Please comment or provide details below to improve the information on BROOK S. WALLACE PA.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.