DR. Jason Wallace, OD

NPI #1689751166 in Celebration, Florida

Provider Information

NPI Number: 1689751166
Entity Type: Individual
Name: DR. Jason Wallace, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Nov 1, 2006
Last Updated: Nov 8, 2017

Practice Location

Address: 502 CELEBRATION AVE
City: Celebration
State: Florida
ZIP Code: 34747-4687
Phone: (407) 566-8505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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