| NPI | 1619011830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MORGAN Office Manager 719-276-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 28791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2124) |
| 363L00000X Nurse Practitioner (Licence: CO np4805) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2012-03-23 |