| NPI | 1457571127 |
|---|---|
| Former Legal Business Name | POUDRE VALLEY FOOT AND ANKLE CLINIC PC |
| Entity Type | Organization |
| Authorized Contact | JAMES CHARLES ANDERSON Owner 970-484-4620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 662) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-10-27 |