Healthcare Provider Details

I. General information

NPI: 1427147081
Provider Name (Legal Business Name): SALLY A KNAVER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 EAST HARMONY ROAD SUITE 290
FORT COLLINS CO
80528
US

IV. Provider business mailing address

2121 EAST HARMONY ROAD SUITE 290
FORT COLLINS CO
80528
US

V. Phone/Fax

Practice location:
  • Phone: 970-224-9890
  • Fax: 970-224-9800
Mailing address:
  • Phone: 970-224-9890
  • Fax: 970-224-9800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SALLY A KNAVER
Title or Position: OWNER
Credential: MD
Phone: 970-224-9890