| NPI | 1679513196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACEANN GRILLO Credentialing Supervisor 720-493-3716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-03-31 |