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General NPI Number Information
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NPI Number | 1013195924
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Entity Type | Organization
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Legal Business Name | FOOT SPECIALIST ASSOCIATES P.C.
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 950 E HARVARD AVE 300
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City | DENVER
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State | CO
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Zip | 80210-7009
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Country | US
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Telephone | 303-722-6864
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Fax |
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Provider Business Mailing Address
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Address Line | 950 E HARVARD AVE 300
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City | DENVER
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State | CO
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Zip | 80210-7009
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Country | US
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Telephone | 303-722-6864
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Fax |
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Authorized Official
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Title or Position | OFFICE MGR.
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Name | MRS. PEGGY J. DAUGHERTY
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Credential |
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Telephone | 303-722-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00402
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License Number State | CO
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