Individual
KATIE ANN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5670 GREENWOOD PLAZA BLVD STE LL110, GREENWOOD VILLAGE, CO 80111-2448
(303) 694-9193
(303) 779-0566
Mailing address
6600 S VINE ST APT 201, CENTENNIAL, CO 80121-2766
(406) 672-2503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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