| NPI | 1053442467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LYNN HALLING Manager 719-632-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO 45066) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2009-04-01 |