Provider Demographics
NPI:1215548904
Name:EXOATLET INC.
Entity Type:Organization
Organization Name:EXOATLET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:720-475-1826
Mailing Address - Street 1:4582 S ULSTER ST STE 205
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3011
Mailing Address - Country:US
Mailing Address - Phone:720-475-1826
Mailing Address - Fax:
Practice Address - Street 1:4582 S ULSTER ST STE 205
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3011
Practice Address - Country:US
Practice Address - Phone:720-475-1826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier