Brandy Wallace

NPI 1457833428 · on the registry since 2018 · sole proprietor

Practice

Address: 56970 Yucca Trl Ste 104
Yucca Valley, CA 92284
Phone: (760) 369-0294
Fax: (760) 369-0295
Organisation at this address: Clarion Optometry Group Prof Corp
Russell R Slaugh Od An Optometric Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 106H00000X
106H00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2018-09-05

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 California