| NPI | 1407258353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE AYLSWORTH SCHULTZ Owner 719-447-0046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CO 1709) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2015-04-13 |