| NPI | 1003496662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MICHAEL VP, Chief Compliance Officer 720-777-6537 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |