| NPI | 1770248189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SMITA PATEL Owner 719-310-6731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-12-13 |