| NPI | 1073146833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASANDRA RICHARDS Credentialing Coordinator 303-440-3076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-10-20 |