| NPI | 1912639642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE JOHNS Credentialer 970-254-1686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |