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1093982647
NANCY WALLER
PUEBLO, CO
NPI
1093982647
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: CO 120)
Enumeration Date
2008-05-13
Last Update Date
2008-05-13
Business Address
Mrs. NANCY WALLER PA
1339 S PUEBLO BLVD
PUEBLO, CO 81005-1508
Phone number: 719-647-5831
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Mailing Address
Mrs. NANCY WALLER PA
1339 S PUEBLO BLVD
PUEBLO, CO 81005-1508
Phone number: 719-647-5831
Copy
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