Roger D Wallis Dcpc

NPI #1083894489 in Fort Lupton, Colorado

Provider Information

NPI Number: 1083894489
Entity Type: Organization
Organization Name: Roger D Wallis Dcpc
Primary Specialty: Chiropractor
Enumeration Date: Nov 14, 2007
Last Updated: Jul 26, 2012

Practice Location

Address: 419 DENVER AVE
City: Fort Lupton
State: Colorado
ZIP Code: 80621-1823
Phone: (303) 857-6344

Authorized Official

Name: DR. ROGER DALE WALLIS, P.C.
Title: PRESIDENT
Phone: (303) 857-6344

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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