Search › Colorado › 111N00000X
Roger Wallis, P.C
NPI 1063615243 · on the registry since 2007 · sole proprietor
Practice
- Address
- 419 Denver Ave
Fort Lupton, CO 80621 - Phone
- (303) 857-6344
- Organisation at this address
- Roger D Wallis Dcpc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Licence states on file
- CO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-12-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado