| NPI | 1396286035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE PITTMAN Authorized Official 719-955-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2019-06-25 |