| NPI | 1316162464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY K PRUTCH Office Manager 719-546-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 23565) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2012-06-13 |