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General NPI Number Information
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NPI Number | 1700498797
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Entity Type | Organization
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Legal Business Name | COLORADO SPORTS MEDICINE AND ORTHOPAEDICS
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 4500 E 9TH AVE STE 420
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City | DENVER
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State | CO
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Zip | 80220-3931
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Country | US
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Telephone | 720-726-7995
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Fax |
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Provider Business Mailing Address
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Address Line | 4071 S DAHLIA ST
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City | CHERRY HILLS VILLAGE
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State | CO
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Zip | 80113-5145
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGEON
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Name | DR. CATHERINE A LOGAN
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Credential | MD
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Telephone | 612-275-6924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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