| NPI | 1649305343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY LEE FOX Csa 720-748-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 92-102) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2013-05-23 |