| NPI | 1326476466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA ELIZABETH GRABLIN Physician Assistant, Co Owner 719-632-0324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2402) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2018-10-31 |