| NPI | 1811205073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY MICHAEL CAVANAUGH Owner/Member 303-604-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 6428) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2010-09-21 |