MR. JAMES LEWIS WALLACE JR. CPO - NPI 1396891933

Q: What is the provider's specialty?

The provider's specialty is Orthotist with taxonomy code 222Z00000X.

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About Mr. James Lewis Wallace Jr. Cpo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JAMES LEWIS WALLACE JR. CPO (NPI 1396891933) is an individual orthotist provider in Charlotte, North Carolina and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1396891933

Entity TypeIndividualMale

Primary Taxonomy222Z00000X

Provider Legal NameMR. JAMES LEWIS WALLACE JR.Credential: CPO

Location Address1901 BRUNSWICK AVE, SUITE 200Charlotte, NC 28207-2809

Mailing AddressPo Box 24905Winston Salem, NC 27114-4905 · (336) 397-2165 · Fax (336) 397-2167

Phone(704) 348-4488

Fax(704) 348-4496

Sole ProprietorNo

Enumeration DateJanuary 26, 2007

Last NPPES UpdateJuly 23, 2010

✔ NPI 1396891933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code222Z00000X

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.

Also ListedProsthetistTaxonomy 224P00000X

1901 BRUNSWICK AVE, Charlotte, NC 28207

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