| NPI | 1538954425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-595-7040 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |