| NPI | 1083665657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATYA LICCIARDI Reimbursement Analyst 970-375-3661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-05-04 |