Individual
WALLACE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3275 E PLATTE AVE STE D2, COLORADO SPRINGS, CO 80909-6444
(719) 694-8855
Mailing address
3275 E PLATTE AVE STE D2, COLORADO SPRINGS, CO 80909-6444
(719) 694-8855
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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