NPI | 1134781867 |
---|---|
Entity Type | Organization |
Authorized Contact | DEAN C MAJOR Cred Spec 719-406-7844 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2019-07-02 |
Last Update Date | 2023-04-06 |