Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LARRY B WALLACE, OD
Active Sole ProprietorLARRY B WALLACE, OD is a Vision Therapy Optometrist healthcare provider located in ITHACA, New York. NPI 1073545059 is currently active in the NPPES registry. Verify at CMS.
Vision Therapy Optometrist · ITHACA, NY
Registration Details
- NPI Number
- 1073545059
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 7, 2006 (20.126086800112 yrs)
- Last Updated
- Oct 6, 2010
- Licenses
-
VUT003212 (NY)VUT003212 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
322 N AURORA STITHACA, NY, 148504202Browse NY providers · Browse ZIP 14850
- Phone
- 6072774749
- Fax
- 6072775216
- Primary Specialty
-
Vision Therapy Optometrist
152WV0400X
- Additional Specialty
- Vision Therapy Optometrist
Other Vision Therapy Optometrist Providers in ITHACA, NY
| Name | Credential | NPI |
|---|---|---|
| DR. TANYA SARAH BLOOM | OD | 1144750035 |
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.