| NPI | 1164558995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN RUTH BURKHARDT Owner 720-200-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 28021) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2011-09-08 |