| NPI | 1023647278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-495-7421 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2024-05-03 |