| NPI | 1144547191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON FABING GIBBS Owner/Provider 719-543-8346 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CO 45004) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2020-11-18 |