| NPI | 1902517626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARRYN FARRELL CFO 970-226-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208100000X Physical Medicine & Rehabilitation | |
| 208D00000X General Practice | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2024-05-07 |