| NPI | 1093338840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L CHINN VP Of Finance 970-298-2020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-01-03 |