| NPI | 1750803722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY A. JACKSON Medical Director / CEO 719-923-3978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |