| NPI | 1194162313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD A JOHNSON President 719-590-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO 24691) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2023-07-12 |