| NPI | 1104494210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA JO SKINNER Administrator, Oma 720-667-7283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2023-07-21 |