| NPI | 1023773611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L ROBICHEAUX Business Manager 719-285-8890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QF0050X Clinic/Center, Family Planning, Non-Surgical |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2025-05-07 |