| NPI | 1114452166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JORDAN WASHBURN Own, Physician 970-518-9394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WY 10738A) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2017-04-27 |