| NPI | 1720587892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA KAE ORCHARD Director Of Operations 970-286-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |