| NPI | 1770053597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE JOHNSON President 720-515-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine | |
| 207LP2900X Anesthesiology Pain Medicine | |
| 207T00000X Neurological Surgery | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |