| NPI | 1477565380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN I ROACH Officer 303-772-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-02-08 |