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 |