| NPI | 1023475563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY CAMELIN Contract Manager 719-761-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225700000X Massage Therapist | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |