Individual
MARY LOU STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
750 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6132
(970) 244-2457
(970) 255-1809
Mailing address
PO BOX 62, GRAND JUNCTION, CO 81502-0062
(970) 244-7050
(970) 255-1809
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2119
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88500268
—
CO
Enumeration date
12/21/2005
Last updated
06/18/2009
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