Healthcare Provider Details

I. General information

NPI: 1457510984
Provider Name (Legal Business Name): LOVELAND FOOT & ANKLE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BOISE AVE
LOVELAND CO
80538-4214
US

IV. Provider business mailing address

1440 BOISE AVE
LOVELAND CO
80538-4214
US

V. Phone/Fax

Practice location:
  • Phone: 970-278-1440
  • Fax: 970-203-0329
Mailing address:
  • Phone: 970-278-1440
  • Fax: 970-203-0329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number379
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER DONALD SCHULTZ
Title or Position: OWNER
Credential: DPM
Phone: 970-278-1440