| NPI | 1902259948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN THOMAS THOMAS Chief, Pediatric Clinic 719-526-7653 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |