| NPI | 1063872661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ANN FUENTES FELTY Owner 720-985-5362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO APN0990735-NP) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |