Individual provider · Type 1 NPI

Mary L. Carollo, P A C

Surgical Physician Assistant · Colorado Springs, CO

NPI number 1508914904 Active

Practice location

175 S Union Blvd, Ste 345
Colorado Springs, CO 80910

Call (719) 471-7158 Map

Fax (719) 471-7159

Mailing address

5955 Wilson Road
Colorado Springs, CO 80919-3553

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X498 (CO)

Surgical Physician Assistant: Definition to come...

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About NPI 1508914904

Mary L. Carollo, P A C's National Provider Identifier is 1508914904, issued on Jan 8, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Colorado Springs, CO. The record was last updated on Jul 8, 2007.