| NPI | 1952938045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARRYN FARRELL CFO 970-631-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-09-03 |