| NPI | 1619045473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK LAWRENCE MALLORY Physician Owner 970-669-9245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 40960) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-01-11 |