| NPI | 1760847008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA ZAPPONE Owner 970-946-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO 0990376) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |