| NPI | 1982204210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE I PITTMAN Practice Administrator 719-632-7641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |