| NPI | 1639617533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE JOHNSON Owner 720-515-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CO CHR.0006922) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: CO CHR.0006922) |
| 261QP3300X Clinic/Center Pain (Licence: CO CHR.0006922) | |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-14 |