MR. BRADFORD WALLACE JR.

Occupational Therapy Assistant

Active Individual
NPI: 1609821636

Practice Address

130 EXECUTIVE DR
Newark, DE 19702

Phone: (302) 292-3454

Specialties

Specialty Code Primary License
Occupational Therapy Assistant 224Z00000X Yes J2-0000629 (DE)

Frequently Asked Questions

NPI 1609821636 is the National Provider Identifier for MR. BRADFORD WALLACE JR., a Occupational Therapy Assistant provider located in Newark, DE. This NPI was enumerated on May 25, 2006.
MR. BRADFORD WALLACE JR. practices at 130 EXECUTIVE DR, Newark, DE 19702.

Quick Facts

NPI
1609821636
Type
Individual
Enumerated
May 25, 2006
Last Updated
Jul 8, 2007

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