Individual
PATRICK MICHAEL CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
350 LYCKMAN PL, FOUNTAIN, CO 80817-2861
(719) 322-0777
(719) 322-0776
Mailing address
2695 ROCKY MOUNTAIN AVE, STE 150, LOVELAND, CO 80538-9071
(970) 624-4036
(970) 490-4378
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002941
CO
363AM0700X
Medical Physician Assistant
2941
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82629579
—
CO
Enumeration date
11/06/2008
Last updated
02/19/2020
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