| NPI | 1558012468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY ANNE DAVIS Assist Practice Admin 970-945-8503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |