| NPI | 1972014785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLA DAWN CLARK Medical/Personal Assistant 303-671-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO 0022177) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |