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Organization

TRACRW LLC

Active
Parent organization
CHARLES WALLACE JR MD
Other names
Treatment Rooms of America CRW
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHARLES WALLACE JR MD
Authorized official
DR. CHARLES R WALLACE MD (PRESIDENT)
(901) 272-3200
Entity
Organization

Contact information

Practice address
995 S YATES RD, SUITE 1, MEMPHIS, TN 38119-0882
(901) 527-7100
Mailing address
995 S YATES RD, SUITE 1, MEMPHIS, TN 38119-0882
(901) 527-7100

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
03/10/2011
Last updated
03/10/2011
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