| NPI | 1497431597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-364-4120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 231H00000X Audiologist |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2024-07-31 |