| NPI | 1992187553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA D ANDERSON Clinical Director 720-624-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 28449) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |