| NPI | 1952038259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWNYA S WARTELL Practice Administrator 303-778-6527 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2023-11-29 |