| NPI | 1205458221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-482-4373 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2024-06-19 |