| NPI | 1801262118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN HAIMES Owner 740-601-6071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 35066575) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-01-07 |