Source 1
NPI #1821321860 in Wheat Ridge, Colorado
Provider Information
- NPI Number
- 1821321860
- Entity Type
- Organization
- Organization Name
- Source 1
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SOURCE 1
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Enumeration Date
- Sep 9, 2009
- Last Updated
- Sep 15, 2009
Practice Location
- Address
- 3550 LUTHERN PARKWAY
- Address 2
- SUITE 210
- City
- Wheat Ridge
- State
- Colorado
- ZIP Code
- 80033
- Phone
- (303) 456-6051
Authorized Official
- Name
- MR. TRACY JOHN FOX
- Title
- OWNER
- Phone
- (303) 324-7674
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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