NPI | 1669871265 |
---|---|
Entity Type | Organization |
Authorized Contact | DESTRIA BENNIS Office Manager 303-357-4040 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004017) |
Enumeration Date | 2014-08-19 |
Last Update Date | 2014-08-19 |