| NPI | 1083433098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-667-7664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207T00000X Neurological Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology | |
| 225100000X Physical Therapist | |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2025-01-14 |