Individual
MARLEYNA AUGUSTEINA ILLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Mailing address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
0009195
AZ
Other
Enumeration date
10/25/2021
Last updated
10/20/2022
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