Individual
MR. JOHN HUGH WALLACE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
319 SPRINGWOOD DR NE, VALDESE, NC 28690-8710
(828) 879-8419
Mailing address
319 SPRINGWOOD DR NE, VALDESE, NC 28690-8710
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
246400
NC
Other
Enumeration date
06/01/2015
Last updated
05/28/2021
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