| NPI | 1497076681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES KOPEL Owner 970-391-4303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-01-15 |