| NPI | 1104860550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A THWAITES Owner/Provider 970-392-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO 2049) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-09-03 |