Whalio Doctors

NPI 1285877217

Courtney Brooke Wallace, PT

Practitioner Contractor Raleigh, NC

Practice location

Address
3601 Windemere Pl, Raleigh, NC 27604-5961
Phone
(919) 601-0149
Mailing address
9802 Carvel CT, Raleigh, NC 27613-5754

Registered specialties

Contractor Primary
Other Service Providers Taxonomy 171W00000X Licence 8974 (NC)

Registry record

NPI
1285877217
Entity type
Individual
Sex (as registered)
Female
NPI issued
6 Apr 2009
Record last updated
22 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.