| NPI | 1710582903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN RODARTE Credentialing/Billing Manager 720-281-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2023-03-01 |