| NPI | 1700322575 |
|---|---|
| Doing Business As | CHAMPIONS FAMILY MEDICAL |
| Entity Type | Organization |
| Authorized Contact | RICHARD B LANE Practice Manager 719-406-9304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |