IndividualActive
Larry Wallace, OD
NPI 1073545059 · Vision Therapy Optometrist · Ithaca, NY
Provider details
- NPI number
- 1073545059
- Entity type
- Individual
- Primary specialty
- Vision Therapy OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- Sole proprietor
- Yes
- License
- VUT003212 (NY)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
322 N Aurora St
Ithaca, NY 14850-4202
Phone: (607) 277-4749
Fax: (607) 277-5216
Approximate (ZIP-level) locationGet directions
Mailing address
322 N. Aurora St.
Ithaca, NY 14850
Registry dates
- Enumerated
- 2006-07-07
- Last updated
- 2010-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.