Search › New Jersey › 152W00000X
Larry Wallis, OD
NPI 1821083585 · on the registry since 2005 · sole proprietor
Practice
- Address
- 14 N Broadway
Gloucester City, NJ 08030 - Phone
- (856) 456-3925
- Fax
- (856) 456-4748
- Organisation at this address
- Dr. Larry Charles Wallis Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-10-30
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 New Jersey