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Search › Wisconsin › 103T00000X

Carly Wallace

NPI 1679483820 · on the registry since 2026

Practice

Address
1919 W North Ave Ste 200
Milwaukee, WI 53205
Phone
(414) 257-7610
Organisation at this address
Medzone Llc
Medzone Llc
Hayat Pharmacy 5 Llc
Shafi Medical Center Sc
Tenderness Medical Center Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
8

Registry record

Primary taxonomy
103T00000X
103T00000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-09-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin