Organization
EAST MEMPHIS OPTOMETRY PROFESSIONAL ASSOCIATION
Active
Other names
Landon J Wallace OD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANDON J WALLACE OD (PRESIDENT)
(901) 683-4529
Entity
Organization
Contact information
Practice address
5118 PARK AVE, SUITE101, MEMPHIS, TN 38117
(901) 683-4529
(901) 767-4404
Mailing address
5118 PARK AVE, SUITE101, MEMPHIS, TN 38117-5720
(901) 683-4529
(901) 767-4404
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639481906
NPI
—
Enumeration date
02/04/2008
Last updated
11/30/2018
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