| NPI | 1710350012 |
|---|---|
| Doing Business As | JACQUELYN NIELSEN |
| Entity Type | Organization |
| Authorized Contact | JACQUELYN JO NIELSEN Owner 970-622-9997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CO R708546) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |