| NPI | 1013678135 |
|---|---|
| Former Legal Business Name | SIMPLY VAX, PLLC |
| Entity Type | Organization |
| Authorized Contact | MELISSA RHOADS Director 970-599-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2022-01-02 |
| Last Update Date | 2022-01-15 |