Healthcare Provider Details

I. General information

NPI: 1235358342
Provider Name (Legal Business Name): NORTHERN COLORADO ORTHOPEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E. HARMONY RD. STE 290
FORT COLLINS CO
80528
US

IV. Provider business mailing address

2121 E. HARMONY RD. STE 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 Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SALLY A KNAUER
Title or Position: OWNER
Credential: MD
Phone: 970-224-9890