| 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 |