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Larry B Wallace, OD
Vision Therapy Optometrist in Ithaca, New York
NPI 1073545059

Larry B Wallace is a Vision Therapy Optometrist based in Ithaca, NY and is specialized in Vision Therapy. Larry B Wallace practices in Ithaca, NY and has the professional credentials of OD. The NPI Number for Larry B Wallace is 1073545059 and holds a License No. VUT003212 (New York).

The current practice location address for Larry B Wallace is 322 N Aurora St, Ithaca, NY and can be reached out via phone at 607-277-4749 and via fax at 607-277-5216. You can also correspond with Larry B Wallace through the mailing address at 322 N. AURORA ST., ITHACA, NY - 14850 (mailing address contact number: 607-277-4749).

Location: 322 N Aurora St, Ithaca, NY, 14850
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073545059
Provider Name
Larry B Wallace
Credential
OD
Provider Entity Type
Individual
Gender
Male
Address
322 N Aurora St, Ithaca, NY, 14850
Phone Number
607-277-4749
Fax Number
607-277-5216
Provider Enumeration Date
07/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
T003212-1 01 NY NY STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
322 N Aurora St
City
Ithaca
State
New York
Zip
14850-4202
Phone Number
607-277-4749
Fax Number
607-277-5216
person
Provider Business Mailing Address Details
Address
322 N Aurora St
City
Ithaca
State
New York
Zip
14850-4202
Phone Number
607-277-4749
Fax Number
607-277-5216
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Optometrist
Speciality
Low Vision Rehabilitation
Taxonomy
152WL0500X
License No.
VUT003212 (New York)
Definition
Optometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and recommend other vision rehabilitation services.
person
Provider's Taxonomy Details 2
Type
Eye and Vision Services Providers
Classification
Optometrist
Speciality
Vision Therapy
Taxonomy
152WV0400X
License No.
VUT003212 (New York)
Definition
Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.
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