Organization
BRO - BOULDER LLC
Active
Parent organization
BREAKTHROUGH REGENERATIVE ORTHOPEDICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
BREAKTHROUGH REGENERATIVE ORTHOPEDICS
Authorized official
DR. TIMOTHY J MAZZOLA MD (SOLE OWNER)
(720) 463-0567
Entity
Organization
Contact information
Practice address
5420 ARAPAHOE AVE STE A, BOULDER, CO 80303-1250
(720) 463-0567
(303) 494-5371
Mailing address
5420 ARAPAHOE AVE STE A, BOULDER, CO 80303-1250
(720) 463-0567
(303) 494-5371
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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