Individual
MALLORY J EASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 BOB PETERS GRV, COLORADO SPRINGS, CO 80909-4533
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0006555
CO
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/04/2017
Last updated
06/07/2023
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