| NPI | 1013034834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BERRIDGE Owner 970-375-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NM 4488) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2020-08-22 |