| NPI | 1104155688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON W MACDONALD Owner 719-687-8034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 7716) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 7810) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2009-12-14 |