| NPI | 1912293374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE S. CASTILLO Owner/Provider 719-225-6510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 4815) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |