| NPI | 1477188274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT J PRIMACK President 719-457-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2022-11-23 |