| NPI | 1982905907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN BRACKETT Practice Manager 719-475-8676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 5766) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO CO28074) |
| 363A00000X Physician Assistant (Licence: CO 00610) | |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2023-08-28 |