| NPI | 1972229920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA GIBSON CFO 970-493-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2023-03-14 |