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General NPI Number Information
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NPI Number | 1477576890
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Entity Type | Organization
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Legal Business Name | STEAMBOAT ORTHOPAEDIC ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 940 CENTRAL PARK DR #190
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-8816
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Country | US
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Telephone | 970-879-4612
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Fax | 970-879-0583
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Provider Business Mailing Address
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Address Line | 940 CENTRAL PARK DR #190
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-8816
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Country | US
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Telephone | 970-879-4612
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Fax | 970-879-0583
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Authorized Official
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Title or Position | ADMINISTRATOR & CFO
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Name | MR. MATTHEW MOSELEY WALTON
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Credential | MBA
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Telephone | 970-879-4612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CO
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