Individual
SHELLEY BROOKE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
101-199 CHEROKEE ST, SPARTANBURG, SC 29303
(336) 995-8611
Mailing address
101-199 CHEROKEE ST, SPARTANBURG, SC 29303
(336) 995-8611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/20/2025
Last updated
10/07/2025
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