Provider Demographics
NPI:1447318225
Name:FLATIRONS SPINE & JOINT HEALTH, LLC
Entity type:Organization
Organization Name:FLATIRONS SPINE & JOINT HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:JACK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-440-8243
Mailing Address - Street 1:777 29TH ST
Mailing Address - Street 2:STE 301
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2316
Mailing Address - Country:US
Mailing Address - Phone:303-440-8243
Mailing Address - Fax:303-440-0292
Practice Address - Street 1:777 29TH STREET
Practice Address - Street 2:STE 301
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2316
Practice Address - Country:US
Practice Address - Phone:303-440-8243
Practice Address - Fax:303-440-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42877261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC809096Medicare PIN