| NPI | 1104125939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER BRODSKY Owner 719-333-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY CON# 071061-B) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2016-01-25 |