MR. Bradford Anthony Wallace JR.

NPI #1609821636 in Newark, Delaware

Provider Information

NPI Number
1609821636
Entity Type
Individual
Name
MR. Bradford Anthony Wallace JR.
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
May 25, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
130 EXECUTIVE DR
City
Newark
ZIP Code
19702-3349
Phone
(302) 292-3454

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant

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