NPI | 1477924728 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT WHIRL Owner 719-452-9808 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO NLC.0013119) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2015-10-13 |