| NPI | 1568559748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BORONSKI Office Manager 970-927-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 30756) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 207Q00000X Family Medicine | |
| 251S00000X Community/Behavioral Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-07-07 |