Individual
MS. STEPHANIE M BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
191 E ORCHARD RD, #102 NE, LITTLETON, CO 80121-8000
(303) 730-1313
(303) 730-2090
Mailing address
191 E. ORCHARD AVE, #102 NE, LITTLETON, CO 80121
(303) 730-1313
(303) 730-2090
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
719
CO
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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