| NPI | 1912372137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN JUNE TYRRELL Benefits Administrator 970-494-7801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 35548) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |