| NPI | 1366196198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-203-7050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2024-07-24 |