NPI | 1558549923 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIANNA E GANTT Office Manager 303-649-1320 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 42037) |
Enumeration Date | 2008-02-07 |
Last Update Date | 2012-02-07 |