NPI | 1881026854 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHY J TOMLISON Owner 720-217-5794 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 8412) |
Enumeration Date | 2013-08-01 |
Last Update Date | 2021-12-01 |