Individual
CHARLES WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 HERITAGE CENTER DR STE 202, WAKE FOREST, NC 27587-9849
(919) 285-4802
Mailing address
1740 HERITAGE CENTER DR STE 202, WAKE FOREST, NC 27587-9849
(919) 285-4802
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12543A
NC
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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