Individual
DR. JACE MICHAEL WAGUSPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2312 N NEVADA AVE STE 100, COLORADO SPRINGS, CO 80907-5307
(719) 473-3272
(719) 389-1191
Mailing address
2312 N NEVADA AVE STE 100, COLORADO SPRINGS, CO 80907-5307
(719) 389-1108
(719) 389-1191
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4908
CO
Other
Enumeration date
09/12/2018
Last updated
08/15/2023
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