| NPI | 1801899794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH HAMSTRA Administrator 719-667-5792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CO 0452) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-11-28 |