| NPI | 1902983950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDRA S OETOMO Clinical Director 303-683-8338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 978) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 3579) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |