Individual
COREY TAIT EASTHAM SOURS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.T. (R)(CT)(ARRT)
Contact information
Practice address
2121 NORTH AVE, GRAND JUNCTION, CO 81501-6428
(970) 242-0731
Mailing address
420 PINTAIL AVE, GRAND JUNCTION, CO 81504-6215
(970) 623-9293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
510729
CO
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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