NPI | 1598399537 |
---|---|
Entity Type | Organization |
Authorized Contact | KATE BOGUE Credentialing 719-632-4455 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 101Y00000X Counselor |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
Enumeration Date | 2020-02-28 |
Last Update Date | 2020-10-25 |