| NPI | 1063749265 |
|---|---|
| Doing Business As | SOURCE 1 - DME |
| Entity Type | Organization |
| Authorized Contact | TRACY JOHN FOX Business Owner 303-952-0396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CO 4274647) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |