Individual
MARY LOUISE CHAMBERLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4455 E 12TH AVE, DENVER, CO 80220-2415
(303) 504-7700
Mailing address
4455 E 12TH AVE, DENVER, CO 80220-2415
(303) 504-6500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0007179
CO
363A00000X
Physician Assistant
PA.1433
AL
Other
Enumeration date
03/05/2019
Last updated
02/28/2022
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