| NPI | 1467786996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GROSS Pharmacist 720-848-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IL 14560) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |