| NPI | 1316406978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARRYN FARRELL CFO 970-631-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-05-06 |