Individual
ANDREW DAVID DAVALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2045 N FRANKLIN ST, DENVER, CO 80205-5437
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 2257
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 2257
STATE LICENSE
CO
Enumeration date
07/25/2006
Last updated
04/28/2021
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