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1497729909
NICHOLE G WALLACE
AURORA, CO
NPI
1497729909
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Former Name
SUZANNE NICHOLE GREEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2080C0008X Pediatrics, Child Abuse Pediatrics
(Licence: CO DR0054149)
Enumeration Date
2006-02-14
Last Update Date
2014-12-09
Business Address
Dr. NICHOLE G WALLACE MD
13123 E 16TH AVE B390
AURORA, CO 80045-7106
Phone number: 303-864-5250
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Mailing Address
Dr. NICHOLE G WALLACE MD
PO BOX 110429
AURORA, CO 80042-0429
Phone number: 303-493-7000
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