| NPI | 1952442600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RANDY DILLON Owner President Md 719-276-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 35220) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2015-11-13 |