| NPI | 1386600104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE MCDERMOTT Patient Account Manager 719-636-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2011-03-11 |