| NPI | 1285139220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA OLSON CEO 719-600-8049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |