B WALLACE

General Practice

Active Individual
NPI: 1518001312

Practice Address

2955 S BROADWAY
Englewood, CO 80113

Phone: (303) 788-1124

Specialties

Specialty Code Primary License
General Practice 208D00000X Yes 11470 (CO)

Frequently Asked Questions

NPI 1518001312 is the National Provider Identifier for B WALLACE, a General Practice provider located in Englewood, CO. This NPI was enumerated on February 16, 2007.
B WALLACE practices at 2955 S BROADWAY, Englewood, CO 80113.

Quick Facts

NPI
1518001312
Type
Individual
Enumerated
Feb 16, 2007
Last Updated
Oct 5, 2007

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