| NPI | 1669131991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN B FARRIS Owner / President 719-362-7848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2023-09-14 |