| NPI | 1760322804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC LEE HETZEL Assistant Secretary 719-380-7325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2026-03-30 |
| Last Update Date | 2026-03-30 |