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1740371699
BETHANY ANN WALLACE
COLORADO SPRINGS, CO
NPI
1740371699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CO 27638)
Enumeration Date
2006-09-27
Last Update Date
2023-05-14
Business Address
-- BETHANY ANN WALLACE do
8890 N UNION BLVD STE 170
COLORADO SPRINGS, CO 80920-2701
Phone number: 719-365-6421
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Mailing Address
-- BETHANY ANN WALLACE do
558 E CASTLE PINES PKWY PMB 151
CASTLE ROCK, CO 80108-4608
Phone number: 719-365-6421
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