| NPI | 1770997637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON CAMPBELL Owner 720-877-1390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 201813) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |