Individual
SUZANNE MARIE SEBALLOZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHREAN CIRCLE, ATTN: CREDENTIALS OFFICE, FORT CARSON, CO 80913-4604
(719) 526-7844
(719) 526-7984
Mailing address
USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHRANE CIRCLE, ATTN: CREDENTIALS OFFICE, FORT CARSAN, CO 80913-4604
(719) 526-7844
(719) 526-7984
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
12853
CO
Other
Enumeration date
01/18/2006
Last updated
07/08/2007
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