| NPI | 1700273083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARRYN LEIGH FARRELL CFO 970-226-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2018-02-22 |