| NPI | 1164061099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET ETHEL MACDONALD President/Owner 719-249-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2021-03-24 |