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1508914904
MARY L CAROLLO
COLORADO SPRINGS, CO
NPI
1508914904
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CO 498)
Enumeration Date
2007-01-08
Last Update Date
2007-07-08
Business Address
Ms. MARY L CAROLLO P A C
175 S UNION BLVD STE 345
COLORADO SPRINGS, CO 80910
Phone number: 719-471-7158
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Mailing Address
Ms. MARY L CAROLLO P A C
5955 WILSON ROAD
COLORADO SPRINGS, CO 80919-3553
Phone number: 719-548-9182
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