| NPI | 1649780602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA KNIGHT Owner/Operator 720-726-1048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CO 34192) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 34192) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2018-03-17 |