| NPI | 1831572759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY VAUGHN SANDELL Owner 719-591-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CO 34408) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |