Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL WALLACE
Active Sole ProprietorMICHAEL WALLACE is a In Home Supportive Care Agency healthcare provider located in FOUNTAIN INN, South Carolina. NPI 1558139428 is currently active in the NPPES registry. Verify at CMS.
In Home Supportive Care Agency · FOUNTAIN INN, SC
Registration Details
- NPI Number
- 1558139428
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 19, 2023 (2.6975552180068 yrs)
- Last Updated
- Dec 19, 2023
- License
-
IHCP-2020 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1314 N MAIN STFOUNTAIN INN, SC, 296441332Browse SC providers · Browse ZIP 29644
- Phone
- 8646882018
- Fax
- 8644848493
- Primary Specialty
-
In Home Supportive Care Agency
253Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.