| NPI | 1538684196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FEEBACK Credentialing Specialist 970-221-9451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |