NPI | 1881290518 |
---|---|
Doing Business As | ROARING FORK FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | CHARLES CREVLING CFO 970-384-6606 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2020-12-08 |
Last Update Date | 2021-04-28 |