| NPI | 1316274517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK EDWARD HENDERSON Owner 970-249-6968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CO 31899) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |