| NPI | 1235424003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M STRANGE Program Director 719-557-5872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 3209) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |