| NPI | 1568643625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN C SHUM Owner 303-530-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO 4671) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |