| NPI | 1770700544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEL COHEN Executive Directer 719-475-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 36345) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 44858) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |