Individual
DR. LACEY BETH WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
335 PENNY LN, CONCORD, NC 28025-1221
(704) 784-5901
(704) 721-0413
Mailing address
335 PENNY LN, CONCORD, NC 28025-1221
(704) 784-5901
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2018-01570
NC
207N00000X
Dermatology Physician
276541
NY
207N00000X
Dermatology Physician
OS14737
FL
Other
Enumeration date
05/17/2013
Last updated
07/21/2022
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