| NPI | 1144405739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALLEN SEVERANCE Office Manager 970-257-7116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 34092) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2010-06-25 |