| NPI | 1568044162 |
|---|---|
| Doing Business As | CHILDREN'S COLORADO REGIONAL OUTREACH CLINIC - PUEBLO - PHD |
| Entity Type | Organization |
| Authorized Contact | LINDA MICHAEL VP, Chief Compliance Officer 720-777-6537 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-04-22 |