| NPI | 1669584009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON M RUBICK D.O./ Physician Administrator 719-597-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |