| NPI | 1013347954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D CRAIG LOUCKS Owner 303-699-7325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 40906) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |