| NPI | 1205003084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEON MALMGREN Director 303-450-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 40901) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 3160) |
| 363AM0700X Physician Assistant Medical (Licence: CO 610) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |