| NPI | 1881788537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WAYNE SULLINGER President 970-252-9165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 39301) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-07-30 |