| NPI | 1972229920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MALOUFF Facilities Director 970-443-8268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-05-27 |