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Individual

CARLY ANN MOMPELLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2450 S PEORIA ST STE 245, AURORA, CO 80014-5475
(303) 752-7732
(720) 848-9112
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4451
(970) 490-4173

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015053
NY
363A00000X
Physician Assistant
Primary
PA.0006278
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000186067
CO
Enumeration date
09/09/2011
Last updated
05/17/2023
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