| NPI | 1033747142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP W RHOADS Owner 970-599-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |