| NPI | 1669211348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON BAILEY Officer/Authorized Official 970-331-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2026-03-19 |