| NPI | 1710150800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GLENN COUSER Owner 303-423-1925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 15-65905-0000) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |