Individual
COREY D. MOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
701 E HAMPDEN AVE STE 515, ENGLEWOOD, CO 80113-3880
(303) 209-2503
(303) 761-0803
Mailing address
4900 S MONACO ST STE 210, DENVER, CO 80237-3487
(303) 209-2503
(303) 761-0803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-002802
IL
363A00000X
Physician Assistant
Primary
3075
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40929701
—
CO
Enumeration date
09/06/2006
Last updated
01/27/2022
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