Search › Ohio › 376J00000X
Jacob Wallace
NPI 1306709852 · on the registry since 2025 · sole proprietor
Practice
- Address
- 860 Garver Rd
Middletown, OH 45044 - Phone
- (513) 300-4203
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 376J00000X
376J00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-12-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio