| NPI | 1376058743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JAMES SIMERVILLE Owner 719-581-7123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 44566) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 44566) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |