| NPI | 1720685894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MILENSKI Billing Department Manager 719-471-1763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2024-09-05 |