| NPI | 1992973473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RIVERA Owner 719-564-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CO 19885) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2021-04-21 |