| NPI | 1689274318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGERLISA WENCHE MATTOCH Owner / Authorized Rep 970-818-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |