| NPI | 1063746857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE R. CONRAD Owner/Manager 719-596-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CO CHR-5831) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-09-25 |