Individual
ROBERT T WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED.
Contact information
Practice address
2001 E 7TH ST, CHARLOTTE, NC 28204-3311
(704) 334-1860
(704) 347-2785
Mailing address
2001 E 7TH ST, CHARLOTTE, NC 28204-3311
(704) 334-1860
(704) 347-2785
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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