| Organization Name: | FOOT SURGERY CENTER OF NORTHERN COLORADO LLC |
| NPI Number: | 1013116938 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES CHARLES ANDERSON (OWNER) |
| Mailing Address: | 1355 Riverside Ave Suite B Fort Collins |
| State: | CO US |
| Postal Code: | 80524 |
| Phone Number: | 9704844620 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2007 |
| NPI Last Update Date: | 10/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |