| NPI | 1841479037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM J CARLSEN President 719-260-6604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CO 642) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |