| NPI | 1275139610 |
|---|---|
| Doing Business As | ROARING FORK FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | CHARLES CREVLING CFO 970-384-6606 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2020-12-10 |