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General NPI Number Information
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NPI Number | 1215380886
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Entity Type | Organization
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Legal Business Name | DELTA ORTHOPEDICS, LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 257 COTTONWOOD ST
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City | DELTA
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State | CO
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Zip | 81416-4400
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Country | US
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Telephone | 970-399-4200
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Fax | 970-399-4219
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Provider Business Mailing Address
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Address Line | 22411 T RD
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City | CEDAREDGE
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State | CO
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Zip | 81413-8318
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Country | US
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Telephone | 970-399-4200
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Fax | 970-399-4219
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN P KNUTSON
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Credential | MD
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Telephone | 970-399-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 42654
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License Number State | CO
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