MEDICARE: DR. BROOK STEPHEN WALLACE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2625	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0836G	OTHER	NC	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881624989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BROOK STEPHEN WALLACE DC

Provider Business Mailing Address
First Line	:	1000 N MAIN ST
Second Line	:	SUITE 101
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-2056
Country	:	US
Telephone Number	:	919-577-0660
Fax Number	:	919-577-2286

Provider Business Practice Location Address
First Line	:	1000 N MAIN ST
Second Line	:	SUITE 101
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-2056
Country	:	US
Telephone Number	:	919-577-0660
Fax Number	:	919-577-2286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1780686014 — KENNETH WILLIAM ROACH M.D.
Practice Location Address:

1000 N MAIN ST , SUITE #204
FUQUAY VARINA, NC
27526-2056

Practice Phone: 919-567-3709
Practice Fax:

1306915731 — BROOK S. WALLACE PA
Practice Location Address:

1000 N MAIN ST , SUITE 101
FUQUAY VARINA, NC
27526-2056

Practice Phone: 919-577-0660
Practice Fax: 919-577-2286

1205978061 — MICHAELE LYNN WORRIX LPC, ATR
Practice Location Address:

1000 N MAIN ST , SUITE 202
FUQUAY VARINA, NC
27526-2056

Practice Phone: 919-285-4963
Practice Fax: 919-285-4964

1386913507 — RIGHT FOUNDATON INC
Practice Location Address:

1000 N MAIN ST STE 106
FUQUAY VARINA, NC
27526-2056

Practice Phone: 910-485-0071
Practice Fax: 407-479-3846

1992108203 — AT HOME SENIOR SERVICES
Practice Location Address:

1000 N MAIN ST , SUITE 219
FUQUAY VARINA, NC
27526-2056

Practice Phone: 919-606-1739
Practice Fax:

1366024168 — HOMECHOICE OF COASTAL CAROLINA, LLC
Practice Location Address:

1000 N MAIN ST STE 102
FUQUAY VARINA, NC
27526-2056

Practice Phone: 919-557-4663
Practice Fax:

Directions to “ DR. BROOK STEPHEN WALLACE DC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.