Individual
DOUGLAS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
95 POST OFFICE PARK, WILBRAHAM, MA 01095-1248
(413) 599-0430
Mailing address
128 GARLAND ST, SPRINGFIELD, MA 01118-2219
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
494
MA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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