Provider Demographics
NPI:1619316288
Name:ASCHENBRENNER, MALLORI (OD)
Entity Type:Individual
Prefix:DR
First Name:MALLORI
Middle Name:
Last Name:ASCHENBRENNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 RED CEDAR DR
Mailing Address - Street 2:UNIT D1
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8152
Mailing Address - Country:US
Mailing Address - Phone:303-471-2244
Mailing Address - Fax:
Practice Address - Street 1:4008 RED CEDAR DR
Practice Address - Street 2:UNIT D1
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-8152
Practice Address - Country:US
Practice Address - Phone:303-471-2244
Practice Address - Fax:303-471-7879
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2984152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist