| NPI | 1427630920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA CAMPBELL Billing Manager 970-351-2412 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |