Individual
CATHERINE LAUREN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
930 3RD ST, GREENSBORO, NC 27405-6967
(336) 890-3200
(336) 890-3290
Mailing address
1125 N CHURCH ST, GREENSBORO, NC 27401-1007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
218000
NC
Other
Enumeration date
03/29/2016
Last updated
08/19/2021
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