| NPI | 1992116461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY HERRERA KAPLAN Member 970-402-0575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 1622) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CO 10831) |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2014-05-18 |