| NPI | 1902275936 |
|---|---|
| Doing Business As | CHPG PHYSICAL MEDICINE CHURCH RANCH |
| Entity Type | Organization |
| Authorized Contact | SUE JARDON Administrator 719-571-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |