Organization Name: | HIGH PLAINS FOOT AND ANKLE CLINIC |
NPI Number: | 1366650640 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORIN S BRANDON (OWNER) |
Mailing Address: | 411 Main St Ste 202 Fort Morgan |
State: | CO US |
Postal Code: | 807012136 |
Phone Number: | 9705420221 |
Fax Number: | 9705429585 |
NPI Enumeration Date: | 05/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP1100X |
License Number: | 506 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Podiatric |
Taxonomy Definition: |