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 |