Jason Ryan Mammino

NPI #1548757073 in Castle Rock, Colorado

Provider Information

NPI Number: 1548757073
Entity Type: Individual
Name: Jason Ryan Mammino
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dermatology
Enumeration Date: Apr 19, 2018
Last Updated: May 1, 2023

Practice Location

Address: 4344 WOODLANDS BLVD STE 160
City: Castle Rock
State: Colorado
ZIP Code: 80104-2801
Phone: (303) 350-4500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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