| NPI | 1114220738 |
|---|---|
| Doing Business As | WALLACE VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | AUGUST M WALLACE Owner 803-201-8526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1483) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2010-12-21 |