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1285877217
COURTNEY BROOKE WALLACE
RALEIGH, NC
NPI
1285877217
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: NC 8974)
Enumeration Date
2009-04-06
Last Update Date
2021-01-22
Business Address
COURTNEY BROOKE WALLACE PT
3601 WINDEMERE PL
RALEIGH, NC 27604-5961
Phone number: 919-601-0149
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Mailing Address
COURTNEY BROOKE WALLACE PT
9802 CARVEL CT
RALEIGH, NC 27613-5754
Phone number: 984-200-2415
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