Individual
ANNE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1006 CENTRE AVE, FORT COLLINS, CO 80526-1849
(970) 482-9001
Mailing address
1006 CENTRE AVE, FORT COLLINS, CO 80526-1849
(970) 482-9001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
58303
CO
Other
Enumeration date
08/02/2006
Last updated
07/21/2022
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