| NPI | 1801132576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK LAWRENCE MALLORY Owner/Physician 9706-669-9245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 40960) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |