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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. COLLEEN THERESE WALLACE, COTA

Active Sole Proprietor

Skilled Nursing Facility · ARPIN, WI

Registration Details

NPI Number
1992043210
Provider Type
Individual
Gender
Female
NPI Issued
Jan 21, 2013 (13.24737224174 yrs)
Last Updated
Jan 21, 2013
License
1032-27 (WI)
Sole Proprietor
Yes

Practice Information

Address
9286 ARPIN RICHFIELD RD
ARPIN, WI, 544109514
Browse WI providers · Browse ZIP 54410
Phone
7158974213
Primary Specialty
Skilled Nursing Facility
314000000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.