| NPI | 1548069891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 719-595-7680 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-10 |