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Individual

SUSAN MACLEAN WALCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CNIM

Contact information

Practice address
14140 FAIRWAY LN, BROOMFIELD, CO 80020-9564
(303) 425-3213
(303) 466-9772
Mailing address
9154 W PHILLIPS DR, LITTLETON, CO 80128-8121
(303) 904-0618
(303) 904-0618

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
03/17/2007
Last updated
07/08/2007
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