| NPI | 1104561695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLIE FLANIGAN Physician Assistant 970-846-7816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |