| NPI | 1639529738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT HERRON Owner 720-485-3178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-09-19 |