Individual
CONNOR WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, LSW
Contact information
Practice address
5701 N HIGH ST STE 308, WORTHINGTON, OH 43085-3960
(614) 406-0299
Mailing address
74 UNITED CROSSING RD UNIT 74L, COLUMBUS, OH 43235-1179
(740) 963-2554
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
02/26/2024
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