Individual
DR. LANDON J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5118 PARK AVE STE 101, MEMPHIS, TN 38117-5710
(901) 683-4529
(901) 767-4404
Mailing address
5118 PARK AVE STE 101, MEMPHIS, TN 38117-5710
(901) 683-4529
(901) 767-4404
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2934
TN
Other
Enumeration date
07/02/2010
Last updated
05/11/2018
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