| NPI | 1639619257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI COX Management 970-516-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-09-19 |