| NPI | 1972195220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUN CHEN CLEGG Owner 970-208-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 227800000X Respiratory Therapist, Certified | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |