| NPI | 1457531808 |
|---|---|
| Doing Business As | FAMILY MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVID MANTER Owner 970-352-3274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 30988) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2013-09-25 |