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Individual

JASON RYAN MAMMINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4344 WOODLANDS BLVD STE 160, CASTLE ROCK, CO 80104-2801
(303) 350-4500
Mailing address
4344 WOODLANDS BLVD STE 160, CASTLE ROCK, CO 80104-2801
(303) 350-4500

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0066760
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/19/2018
Last updated
05/01/2023
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