Individual
DR. WALLACE BULLARD GUERRANT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3180 RICHMOND RD, LEXINGTON, KY 40509-1596
(859) 721-1827
(859) 335-1535
Mailing address
3180 RICHMOND RD, LEXINGTON, KY 40509-1596
(859) 721-1827
(859) 335-1535
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1214DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100054840
—
KY
Enumeration date
12/18/2006
Last updated
03/31/2017
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