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Mr. James Lewis Wallace JR., CPO
Prosthetist in Charlotte, North Carolina
NPI 1396891933

James Lewis Wallace JR. is a Prosthetist based in Winston Salem, NC. James Lewis Wallace JR. practices in Charlotte, NC and has the professional credentials of CPO. The NPI Number for James Lewis Wallace JR. is 1396891933 and holds a License No. (North Carolina).

The current practice location address for James Lewis Wallace JR. is 1901 Brunswick Ave, Charlotte, NC and can be reached out via phone at 704-348-4488 and via fax at 704-348-4496.

Location: 1901 Brunswick Ave, Charlotte, NC, 27114-4905
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396891933
Provider Name
James Lewis Wallace JR.
Credential
CPO
Provider Entity Type
Individual
Gender
Male
Address
1901 Brunswick Ave, Charlotte, NC, 27114-4905
Phone Number
704-348-4488
Fax Number
704-348-4496
Provider Enumeration Date
01/26/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7795261 05 NC
institution
Provider Business Practice Location Address Details
Address
1901 Brunswick Ave
City
Charlotte
State
North Carolina
Zip
28207-2809
Phone Number
704-348-4488
Fax Number
704-348-4496
person
Provider Business Mailing Address Details
Address
1901 Brunswick Ave
City
Charlotte
State
North Carolina
Zip
28207-2809
Phone Number
704-348-4488
Fax Number
704-348-4496
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotist
Speciality
-
Taxonomy
222Z00000X
License No.
()
Definition
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Prosthetist
Speciality
-
Taxonomy
224P00000X
License No.
()
Definition
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
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