MR. ISAAC GALEN WALLACE (NPI# 1730227216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730227216 |
| Entity Type | Individual |
| Full Name | MR. ISAAC GALEN WALLACE |
| Credential | LMBT |
| Practice Address |
3326 Chapel Dr # 230 Durham NC 27708-9964 |
| Practice Telephone | 9192518437 |
| Mailing Telephone | 9192518437 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2019-07-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 9478 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MASSAGE LICENSE | 9478 | 01 |
| Street Address |
3326 CHAPEL DR # 230 |
| City | DURHAM |
| State | NC |
| Zip Code | 27708-9964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306129952 | Ellen Kay Hawk | Pharmacist | 305 Towerview Dr, Durham, NC 27708 | 2011-09-20 |
| 1134625262 | Latoya S Adkins | Social Worker | 305 Towerview Dr, Durham, NC 27708 | 2018-04-05 |
| 1023518156 | Jillian Gonyea | Specialist/Technologist | 120 Whitford Dr, Durham, NC 27708 | 2018-02-15 |
| 1194346080 | Kristina Hall | Specialist/Technologist | 110 Whitford Dr Murray Athletic Training Room, Durham, NC 27708-0001 | 2020-05-01 |
| 1760018113 | Devin Demyanovich | Specialist/Technologist | 110 Whitford Drive Wd Murray Building Rm 212, Durham, NC 27708-0001 | 2020-03-18 |
| 1891033387 | Guiling Yang | Nurse Practitioner | Duke University Outpatient 1a, Durham, NC 27708-0001 | 2013-01-18 |
| 1215135975 | Nicholas Daniel Potter | Physical Therapist | 118 Cameron Indoor Stadium, Box 90555, Durham, NC 27708-0001 | 2007-07-04 |
| 1265442743 | Julianne Murdoch O'daniel | Genetic Counselor, MS | 101 Science Dr, Suite 2120, Duke Univ Box 3382, Durham, NC 27708-0001 | 2006-08-08 |
| 1376565408 | Jose Fonseca | Specialist/Technologist | Duke University, 118 Cameron Indoor Stadium, Durham, NC 27708-0001 | 2006-07-25 |
| 1093332637 | Ann Hill | Dietitian, Registered | 20 Duke Medicine Circle, Durham, NC 27708-0001 | 2020-06-30 |
| Find all providers in zip 27708 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133183 | Nick Van Ngo | Massage Therapist | 6208 Fayetteville Rd Ste 101, Durham, NC 27713-6286 | 2020-10-29 |
| 1356955991 | Amanda Foy | Massage Therapist | 1103 Virginia Ave # Rs, Durham, NC 27705-3261 | 2020-09-01 |
| 1780208785 | Emma Lani Bufalini | Massage Therapist | 37 Juliette Dr, Durham, NC 27713-6744 | 2020-06-04 |
| 1285266973 | Alexandra Jane Hamer | Massage Therapist | 715 Arnette Ave, Durham, NC 27701-3104 | 2020-02-10 |
| 1164067740 | Alfonso Lamar Smith | Massage Therapist | 4216 Garrett Rd Apt A11, Durham, NC 27707-6159 | 2019-11-07 |
| 1568968766 | Carla B Miller | Massage Therapist | 2232 Page Rd Ste 201, Durham, NC 27703-7724 | 2018-04-05 |
| 1952715567 | Graham Wolfson | Massage Therapist | 718 Iredell St, B, Durham, NC 27705-4881 | 2014-06-12 |
| 1760808398 | Doresha Banks | Massage Therapist | 217 W Geer St Apt 2b, Apt 2b, Durham, NC 27701-2242 | 2014-03-06 |
| 1235409681 | Ivy Jo Staton | Massage Therapist | 4206 N Roxboro St Ste 130, Durham, NC 27704-1868 | 2012-01-03 |
| 1881995256 | Mary D'adamo | Massage Therapist | 915 Orient St, Durham, NC 27701-1818 | 2010-11-16 |
| Find all providers in DURHAM | ||||
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| 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.