| NPI | 1356648414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A MATTOX Owner 970-375-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 9985) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-06-13 |