| NPI | 1023230257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAINE GERRITSEN Billing Agent 303-499-2217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 18076) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-01-09 |