MR. BRADFORD WALLACE JR.
Occupational Therapy Assistant
Active
Individual
NPI: 1609821636
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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