NPI | 1619634698 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA MICHAEL VP, Chief Compliance Officer 720-777-6537 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Enumeration Date | 2021-11-24 |
Last Update Date | 2021-11-24 |