| NPI | 1992526792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BLAKE RODMAN Owner 719-299-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |