| NPI | 1306620075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS CARL CLARK Owner 970-522-1223 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |