Individual
DR. ANDREW WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3822 QUITMAN ST UNIT 2, DENVER, CO 80212-1488
(720) 675-7060
Mailing address
3822 QUITMAN ST UNIT 2, DENVER, CO 80212-1488
(720) 675-7060
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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