John W Wallace JR., LDO
NPI #1730551730 in North Randall, Ohio
Provider Information
- NPI Number
- 1730551730
- Entity Type
- Individual
- Name
- John W Wallace JR., LDO
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician/Technologist - Optician
- Credential
- LDO
- Enumeration Date
- Oct 29, 2015
- Last Updated
- Oct 29, 2015
Practice Location
- Address
- 4840 NORTHFIELD RD
- City
- North Randall
- State
- Ohio
- ZIP Code
- 44128-4524
- Phone
- (216) 475-2160
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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