Doctor Name: | DR. RONALD CHARLES WALLIE |
NPI Number: | 1891748067 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OD |
License Number: | 3576/T1280 |
Business Practice Address: | 115 W Broad St Suite A Newton Falls, OH - 444441572 |
Business Phone Number: | 3308721371 |
Business Fax Number: | 3308721248 |
Mailing Address: | 115 W Broad St, Suite A NEWTON FALLS |
State: | OH |
Postal Code: | 444441572 |
Phone Number: | 3308721371 |
Fax Number: | 3308721248 |
NPI Enumeration Date: | 05/18/2006 |
NPI Last Update Date: | 02/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 3576/T1280 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |