NPI | 1013247667 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN BRUCE CLARK Member 719-481-0021 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CO 11322) |
Enumeration Date | 2010-01-04 |
Last Update Date | 2010-01-04 |