| NPI | 1134275142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE FRYMAN Senior Vice President 719-572-6097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |