| NPI | 1043675101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE DOUGLAS FARMER Owner 720-305-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |