| NPI | 1255704946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS RAY EITEL Owner 719-776-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 21057) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |