Organization
DR TAMMY WALLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMY DARLENE WALLACE OD (OWNER)
(334) 445-3937
Entity
Organization
Contact information
Practice address
1234 ANDREWS AVE, SUITE E, OZARK, AL 36360-3767
(334) 445-3937
(334) 445-3938
Mailing address
1234 ANDREWS AVE, SUITE E, OZARK, AL 36360-3767
(334) 445-3937
(334) 445-3938
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-C02-TA-822
AL
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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