| NPI | 1013643436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE DALTON Director 970-610-0546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 103TH0004X Psychologist, Health |
| 103TH0100X Psychologist, Health Service | |
| 207PE0004X Emergency Medicine, Emergency Medical Services | |
| 207Q00000X Family Medicine | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2023-06-07 |