| NPI | 1932388998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN PURDY WALL Doctor/Owner 970-879-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2009-08-26 |