| NPI | 1609263615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL NISSLER Chief Executive Officer 720-412-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |