| NPI | 1780039669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN RODERICK Owner 720-295-4229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: CO 0002005990) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |