B WALLACE
General Practice
Active
Individual
NPI: 1518001312
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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