| NPI | 1437762028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-364-5080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2024-07-24 |