| Organization Name: | NORTH PARK MEDICAL CLINIC, INC |
| NPI Number: | 1023135597 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDY LARSEN (CLINIC MANAGER) |
| Mailing Address: | 350 Mckinley Street Walden |
| State: | CO US |
| Postal Code: | 80480 |
| Phone Number: | 9707234255 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 04/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |