| NPI | 1043864317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA CAMPBELL Office Manager 970-351-2412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2021-09-30 |