Individual
DR. CHRISTY BANKSTON WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
400 N CASHUA DR, FLORENCE, SC 29501-2098
(843) 664-9393
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-8575
(864) 359-1308
(239) 496-3939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1087
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D10879
—
SC
Enumeration date
01/03/2007
Last updated
04/30/2026
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