| NPI | 1528510302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MINEAR Chief Executive Officer 719-590-1177 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |