| NPI | 1619206638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE RAYMOND BELLEVILLE President 970-223-2274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CO 21657) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2009-12-22 |