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 |