Individual
DR. KATHLENE SUE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HARTSHORN HEALTH SERVICE, COLORADO STATE UNIVERSITY, FORT COLLINS, CO 80523-8031
(970) 491-7121
(970) 491-0226
Mailing address
HARTSHORN HEALTH SERVICE, COLORADO STATE UNIVERSITY, FORT COLLINS, CO 80523-8031
(970) 491-7121
(970) 491-0226
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
30233
CO
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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