| NPI | 1568625549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALAN MOHR Owner 719-275-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 24731) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |