| NPI | 1720084635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN DETWILER Practice Administrator 303-425-9581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 105493) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2008-01-07 |