Individual
CARLY COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 CLUB DR, VALLEJO, CA 94592-1187
(707) 638-5809
Mailing address
900 CAMBRIDGE DR UNIT 55, BENICIA, CA 94510-3627
(562) 292-2080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/21/2024
Last updated
09/27/2024
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