| NPI | 1942698071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE JON LYNCH Practice Administrator Authorized O 970-378-8000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2023-07-20 |