NPI | 1265033526 |
---|---|
Entity Type | Organization |
Authorized Contact | KATE BOGUE Credentialing 719-632-4455 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 101YP2500X Counselor, Professional |
2084P0800X Psychiatry & Neurology, Psychiatry | |
213ES0103X Podiatrist, Foot & Ankle Surgery | |
Enumeration Date | 2020-11-03 |
Last Update Date | 2024-09-16 |