| NPI | 1043759830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE JOHNSON Owner 720-515-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: CO CHR.0006922) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CO CHR.0006922) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CO CHR.0006922) | |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |