Healthcare Provider Details

I. General information

NPI: 1396675245
Provider Name (Legal Business Name): JOSEPH FLOCK MGC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOEY FLOCK MGC

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E HARMONY RD UNIT 170
FORT COLLINS CO
80528-3413
US

IV. Provider business mailing address

2121 E HARMONY RD STE 170
FORT COLLINS CO
80528-3400
US

V. Phone/Fax

Practice location:
  • Phone: 970-237-7700
  • Fax:
Mailing address:
  • Phone: 970-237-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0203X
TaxonomyClinical Molecular Genetics Physician
License NumberXXXXXXXXX
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: