LARRY B WALLACE

ITHACA, NY
NPI1073545059
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152WV0400X Optometrist, Vision Therapy
(Licence: NY  VUT003212)
Additional Taxonomies152WL0500X Optometrist, Low Vision Rehabilitation
(Licence: NY  VUT003212)
Enumeration Date2006-07-07
Last Update Date2010-10-06
Business Address
-- LARRY B WALLACE OD
322 N AURORA ST
ITHACA, NY 14850-4202
Phone number: 607-277-4749
Mailing Address
-- LARRY B WALLACE OD
322 N. AURORA ST.
ITHACA, NY 14850
Phone number: 607-277-4749