Individual
PRESLEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-5432
Mailing address
1819 MARTINS BRANCH RD, CHARLESTON, WV 25312-5607
(304) 543-2092
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112878
WV
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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