Individual
MARY WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4803 WARD RD., WHEAT RIDGE, CO 80033
(303) 421-5005
Mailing address
6475 BRENTWOOD ST, ARVADA, CO 80004-3332
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
108724
CO
Other
Enumeration date
05/22/2007
Last updated
11/05/2007
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