| NPI | 1235458597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAELE DAWN JOHNSON Executive Director 970-350-0135 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO 22494) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2010-05-26 |