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 |