| NPI | 1942560370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOSEPH WILSON Owner/Doctor 970-631-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 6774) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |