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1902426430
DAMON KEITH WALLACE
CHAPEL HILL, NC
NPI
1902426430
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: NC 261375)
Enumeration Date
2020-04-24
Last Update Date
2020-04-24
Business Address
DAMON KEITH WALLACE MD
101 MANNING DR
CHAPEL HILL, NC 27514-4220
Phone number: 919-966-5136
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Mailing Address
DAMON KEITH WALLACE MD
101 MANNING DR
CHAPEL HILL, NC 27514-4220
Phone number:
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