| NPI | 1619365806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON J FORTMEYER Chiropractor 719-346-7052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CO 1730519844) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2015-02-16 |