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Organization
SOURCE 1
Active
Organization
SOURCE 1
Active
Other names
flatirons sports medicine or Source 1- DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY JOHN FOX (OWNER)
(303) 324-7674
Entity
Organization
Contact information
Practice address
3012 MICA CT, SUPERIOR, CO 80027-4548
(303) 554-6699
(303) 554-6700
Mailing address
3012 MICA CT, SUPERIOR, CO 80027-4548
(303) 554-6699
(303) 554-6700
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
4274647
CO
Other
Enumeration date
09/08/2009
Last updated
09/14/2009
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