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Individual

EVAN WALSH MAZUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4085 BURTON ST SE STE 100, GRAND RAPIDS, MI 49546-2444
(616) 233-3599
(616) 385-6030
Mailing address
1060 PLAZA DR, HIGHLANDS RANCH, CO 80129-2344

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303510
MI
225100000X
Physical Therapist
PTL.0013686
CO

Other

Enumeration date
08/09/2017
Last updated
02/05/2025
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