| NPI | 1003099128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA A JOHNSON Office Manager 303-369-1045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CO 280) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CO 280) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2011-09-15 |