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Organization

TRACRW LLC H

Active
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Organization

TRACRW LLC H

Active
Parent organization
CHARLES R WALLACE MD
Other names
Treatment Rooms of America CRWh
Organization subpart
Yes

Provider details

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

Contact information

Practice address
1325 EASTMORELAND AVE, MEMPHIS, TN 38104-3519
(901) 272-3200
Mailing address
1325 EASTMORELAND AVE, MEMPHIS, TN 38104-3519
(901) 272-3200

Taxonomy

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

Other

Enumeration date
04/13/2011
Last updated
04/13/2011
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