| NPI | 1508058710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA JACKSON Office Manager 970-867-4916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CO AW424346) |
| Enumeration Date | 2007-08-11 |
| Last Update Date | 2008-07-17 |