| NPI | 1700442522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HECKER Owner 970-631-8877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |