| NPI | 1073890133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE L GABLE Owner/Operator 719-207-6694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO NP5090) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2012-05-22 |