| NPI | 1942039607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MOORE Owner 970-412-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2024-10-15 |