NPI | 1144763251 |
---|---|
Entity Type | Organization |
Authorized Contact | BRADLEY PRIEBE Physician/CEO 719-445-9902 |
Organization Subpart ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO DR.0054025) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2024-12-06 |