| NPI | 1871018085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER WILSON Owner 720-223-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 53133) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-11-27 |