Jason R Wallace, DO
NPI #1992020937 in Pagosa Springs, Colorado
Provider Information
- NPI Number
- 1992020937
- Entity Type
- Individual
- Name
- Jason R Wallace, DO
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- DO
- Enumeration Date
- Apr 1, 2010
- Last Updated
- Jul 22, 2020
Practice Location
- Address
- 95 S PAGOSA BLVD
- City
- Pagosa Springs
- State
- Colorado
- ZIP Code
- 81147-8329
- Phone
- (970) 731-3700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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