| NPI | 1972009637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON P LANEHART Owner 719-301-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2019-06-11 |