| NPI | 1275943201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W RAFER LEACH Owner 303-870-8870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CO 38790) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-04-29 |