| NPI | 1083717219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA CECILE FRALEY Physician Administrator/ CEO 970-375-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 33703) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-06-29 |