| Devereux Cleo Wallace | |
|
8405 Church Ranch Blvd Westminster CO 80021-3918 | |
| (800) 456-2536 | |
| Not Available |
| Full Name | Devereux Cleo Wallace |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8405 Church Ranch Blvd, Westminster, Colorado |
| Authorized Official Name and Position | Anthony Mckeever (NATL DIRECTOR ACCOUNTS RECEIVABLE) |
| Authorized Official Contact | 6105423064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Devereux Cleo Wallace 8405 Church Ranch Blvd Westminster CO 80021-3918 Ph: (800) 456-2536 | Devereux Cleo Wallace 8405 Church Ranch Blvd Westminster CO 80021-3918 Ph: (800) 456-2536 |
| NPI Number | 1417460791 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 11/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417460791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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