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General NPI Number Information
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NPI Number | 1992208631
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SURGERY AND SPORTS
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 850 W IRONWOOD DR STE 202
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4903
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Country | US
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Telephone | 208-664-2175
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Fax | 208-664-1226
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Provider Business Mailing Address
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Address Line | 850 W IRONWOOD DR STE 202
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4903
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Country | US
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Telephone | 208-664-2175
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Fax | 208-664-1226
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LORI A SAUVE
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Credential |
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Telephone | 208-664-2175
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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