Individual
MRS. ASHLEY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 LAKE BOONE TRL STE B, RALEIGH, NC 27608-1052
(919) 825-1212
Mailing address
106 LAKE BOONE TRL STE B, RALEIGH, NC 27608-1052
(919) 825-1212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11252
NC
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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