| NPI | 1417402918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLOYD B RUSSAK Owner/Physician 303-591-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 35559) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2019-05-29 |