Organization
WALLACE ANESTHESIA SERVICES INCORPORATED
Active
Organization
WALLACE ANESTHESIA SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL RENEE WALLACE CRNA (DIRECTOR)
(918) 284-2163
Entity
Organization
Contact information
Practice address
1311 N MILDRED RD, CORTEZ, CO 81321-2231
(970) 565-6666
Mailing address
35505 ROAD K.1, MANCOS, CO 81328-8978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
08/23/2022
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