| NPI | 1356410666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY SIMPSON Provider Enrollment Manager 720-381-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2024-03-05 |