| NPI | 1114974037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA PIERCE Director 970-865-2665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-04-28 |