| NPI | 1447655709 | 
|---|---|
| Doing Business As | CENTURA HEALTH PHYSICIAN GROUP CHURCH RANCH SPORTS MEDICINE | 
| Entity Type | Organization | 
| Authorized Contact | ANGELA SKINNER Oma Administrator 303-673-7175  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Enumeration Date | 2014-10-29 | 
| Last Update Date | 2016-04-28 |