Individual
MARK W MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
42234 MINNESOTA CREEK RD UNIT G, PAONIA, CO 81428-8125
(970) 765-8551
Mailing address
PO BOX 1664, PAONIA, CO 81428-1664
(970) 765-8551
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171WH0202X
—
CO
Enumeration date
01/06/2019
Last updated
01/06/2019
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