| NPI | 1083814883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DIPERSIO Office Manager 719-584-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: CO 531) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-12-13 |