| NPI | 1780046706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE PALUMBO Credentialing Manager 970-315-4018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-07-21 |