Individual
MITCHELL J MAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCO
Contact information
Practice address
2155 HOLLOW BROOK DR, STE 40, COLORADO SPRINGS, CO 80918-1451
(719) 272-6416
(719) 272-6408
Mailing address
2155 HOLLOW BROOK DR, STE 40, COLORADO SPRINGS, CO 80918-1451
(719) 272-6416
(719) 272-6408
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07137214
—
CO
01
—
364478259
TRICARE
—
Enumeration date
06/22/2006
Last updated
02/10/2020
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