| NPI | 1649787599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STORMIE S BAXTER Owner, CEO 720-642-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 53459) |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2018-01-01 |