NPI | 1154328508 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY KIRK POPHAM Physician 303-468-8844 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CO 0471) |
Enumeration Date | 2005-06-30 |
Last Update Date | 2020-08-22 |