| NPI | 1992171219 |
|---|---|
| Doing Business As | CENTURA HEALTH PHYSICIAN GROUP PRIMARY CARE BROADMOOR |
| Entity Type | Organization |
| Authorized Contact | ANGELA SKINNER Oma / Administrator 303-673-7175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-04-20 |