NPI | 1659504454 |
---|---|
Other Name | WZUPDOC |
Entity Type | Organization |
Authorized Contact | GARY BLANE CHILDERS Owner 719-579-0900 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO CO30910) |
Enumeration Date | 2009-08-26 |
Last Update Date | 2009-08-26 |