Healthcare Provider Details

I. General information

NPI: 1356096366
Provider Name (Legal Business Name): FLATIRONS SPINE & JOINT HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 29TH ST STE 301
BOULDER CO
80303-2316
US

IV. Provider business mailing address

777 29TH STREET STE 301
BOULDER CO
80303-2316
US

V. Phone/Fax

Practice location:
  • Phone: 303-440-8243
  • Fax: 303-440-0292
Mailing address:
  • Phone: 303-440-8243
  • Fax: 303-440-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STANLEY JACK
Title or Position: OWNER-PHYSCIAN
Credential: D.O.
Phone: 303-440-8243