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Mr. Isaac Galen Wallace, LMBT
Massage Therapist in Durham, North Carolina
NPI 1730227216

Isaac Galen Wallace is a Massage Therapist based in Durham, NC. Isaac Galen Wallace practices in Durham, NC and has the professional credentials of LMBT. The NPI Number for Isaac Galen Wallace is 1730227216 and holds a License No. 9478 (North Carolina).

The current practice location address for Isaac Galen Wallace is 3326 Chapel Dr # 230, Durham, NC and can be reached out via phone at 919-251-8437.

Location: 3326 Chapel Dr # 230, Durham, NC, 27708-9964
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730227216
Provider Name
Isaac Galen Wallace
Credential
LMBT
Provider Entity Type
Individual
Gender
Male
Address
3326 Chapel Dr # 230, Durham, NC, 27708-9964
Phone Number
919-251-8437
Fax Number
Provider Enumeration Date
02/05/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9478 01 NC MASSAGE LICENSE
institution
Provider Business Practice Location Address Details
Address
3326 Chapel Dr # 230
City
Durham
State
North Carolina
Zip
27708-9964
Phone Number
919-251-8437
Fax Number
person
Provider Business Mailing Address Details
Address
3326 Chapel Dr # 230
City
Durham
State
North Carolina
Zip
27708-9964
Phone Number
919-251-8437
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
9478 (North Carolina)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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