| NPI | 1932501202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN VAN KONYNENBURG Business Owner 303-776-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CO 42439) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |