NPI | 1205283629 |
---|---|
Entity Type | Organization |
Authorized Contact | DARCY KOEHN President 037-209-3693 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0051221) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992915-NP) |
Enumeration Date | 2016-05-16 |
Last Update Date | 2020-06-03 |