Healthcare Provider Details

I. General information

NPI: 1346906443
Provider Name (Legal Business Name): PODIATRY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 LIMELIGHT AVE STE 200
CASTLE ROCK CO
80109-8034
US

IV. Provider business mailing address

7505 VILLAGE SQUARE DR STE 101
CASTLE PINES CO
80108-3693
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-5156
  • Fax: 303-805-5157
Mailing address:
  • Phone: 303-805-5156
  • Fax: 303-805-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA S CLASSEN
Title or Position: PRESIDENT
Credential: DPM
Phone: 303-805-5156