Individual
MALLORY WANSERSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
710 N SUMMIT BLVD UNIT 103, FRISCO, CO 80443-5666
(970) 368-6908
(970) 368-6910
Mailing address
PO BOX 5584, FRISCO, CO 80443-5584
(970) 406-2559
(970) 453-2365
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0017354
CO
225100000X
Physical Therapist
15240-24
WI
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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