| NPI | 1902684558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON POOLE Employee 303-704-2235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 171W00000X Contractor |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-05-14 |