| NPI | 1245392612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE J BRAEUTIGAM Credentialing Coordinator 970-256-5243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 225X00000X Occupational Therapist | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 225100000X Physical Therapist | |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2025-09-08 |