COLLEEN ELIZABETH WALLACE

LONGMONT, CO
NPI1568187904
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CO  PA.0007479)
Enumeration Date2022-10-07
Last Update Date2023-09-27
Business Address
COLLEEN ELIZABETH WALLACE PA-C
600 S AIRPORT RD BLDG D
LONGMONT, CO 80503-6476
Phone number: 303-494-2705
Mailing Address
COLLEEN ELIZABETH WALLACE PA-C
600 S AIRPORT RD STE D
LONGMONT, CO 80503-6424
Phone number: