| NPI | 1124202536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A WANCIK Office Manager 303-830-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO 39773) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 39773) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2013-03-19 |