| NPI | 1912283045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MALLETT Owner 720-670-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CO 650) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2014-06-09 |