| Organization Name: | SPORTS AND ORTHOPAEDIC SPECIALISTS, PA |
| NPI Number: | 1194751552 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM EVANS (OPERATIONS MANAGER) |
| Mailing Address: | 8100 W 78th St Suite 225 Edina |
| State: | MN US |
| Postal Code: | 554392516 |
| Phone Number: | 9529469777 |
| Fax Number: | 9529469888 |
| NPI Enumeration Date: | 06/25/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |