# NORTHERN COLORADO FOOT AND ANKLE CLINICS PROFESSIONAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184137762
- **Authorized official:** DR. BLAKE HINES DPM (PODIATRIST/OWNER)
- **Authorized official phone:** (417) 389-2203

## Contact information

- **Practice address:** 12201 PECOS ST STE 400, WESTMINSTER, CO 80234-3994
- **Practice address phone:** (303) 469-9292
- **Practice address fax:** (303) 438-8951
- **Mailing address:** 3306 ABBEY RD UNIT 713, EVANS, CO 80620-8623
- **Mailing address phone:** (417) 389-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | POD.0000803 | CO | Yes |

## Other

- **Enumeration date:** 11/06/2017
- **Last updated:** 12/27/2017