| NPI | 1295807543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY J ESPINOZA Office Manager 719-546-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 27511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 30639) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-03-23 |