| NPI | 1770390411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL D CHRISTOPHERSON Owner 970-975-1362 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-16 |