| NPI | 1255495990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC C CARLSON Treasurer 719-275-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CO 162) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2007-11-13 |