| NPI | 1285235127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE BOGUE Credentialing 719-632-4455 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-12-09 |