NPI | 1508452061 |
---|---|
Entity Type | Organization |
Authorized Contact | CLARK STEVEN MCCOY President 970-493-9193 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2020-12-17 |
Last Update Date | 2020-12-17 |