Individual provider · Type 1 NPI

Trevor Dewitt Wallace

Contractor · Suwanee, GA

NPI number 1003339094 Active

Practice location

571 Eva Kennedy Rd Apt 8
Suwanee, GA 30024-3008

Specialties and licenses

TaxonomyCodeLicense
Contractor Primary 171W00000XNone listed

Contractor: For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no re…

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About NPI 1003339094

Trevor Dewitt Wallace's National Provider Identifier is 1003339094, issued on Jul 20, 2017. The primary taxonomy on file is Contractor (171W00000X), and the practice location is in Suwanee, GA. The record was last updated on Jul 21, 2022.