NPI | 1265801401 |
---|---|
Entity Type | Organization |
Authorized Contact | RUSSELL MCCOY Director 720-685-0001 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 20020848) |
Enumeration Date | 2015-09-17 |
Last Update Date | 2015-09-17 |