| NPI | 1982766895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D MOORE Owner 719-574-9889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: CO 69886) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |