| NPI | 1912200718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TREY DODSON Program Director 303-430-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 48421) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2010-12-16 |