| NPI | 1760531883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MENAPACE Office Manager 303-850-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 1456) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-01-05 |