| NPI | 1124396718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN M IRWIN Clinic Director 970-222-7327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 49380) |
| Additional Taxonomies | 111NR0400X (Licence: CO 5759) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2014-01-06 |