| NPI | 1275709677 |
|---|---|
| Doing Business As | WALLACE FOOT CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFREY B PUPP Owner 910-285-3362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NC 449) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: NC 230) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |