Organization
BOULDER SPORT AND SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ERIC FRIEDER DC, CCSP (OWNER)
(303) 494-0944
Entity
Organization
Contact information
Practice address
3400 TABLE MESA DR STE 201, BOULDER, CO 80305-5850
(303) 494-0944
(303) 494-8678
Mailing address
3400 TABLE MESA DR STE 201, BOULDER, CO 80305-5850
(303) 494-0944
(303) 494-8678
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
3053
CO
Other
Enumeration date
08/24/2006
Last updated
07/17/2008
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