| NPI | 1376686691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PELHAM PORTER STAPLES Owner President 719-275-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 30880) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |