| NPI | 1770892085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE FARRELL Clinic Director 970-226-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO NP990032) |
| Additional Taxonomies | 111NR0400X (Licence: CO CHR-5953) |
| 111NR0400X (Licence: CO CHR-5887) | |
| 208D00000X General Practice (Licence: CO 49380) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 990425) | |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2012-11-28 |