# MOUNTAIN VISTA ORTHOPAEDICS

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

## Provider details

- **NPI number:** 1205881174
- **Authorized official:** LORI MALONE (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (970) 348-0020

## Contact information

- **Practice address:** 5890 W 13TH ST, 101, GREELEY, CO 80634-4816
- **Practice address phone:** (970) 348-0020
- **Practice address fax:** (970) 348-0055
- **Mailing address:** 5890 W 13TH ST, 101, GREELEY, CO 80634-4816
- **Mailing address phone:** (970) 348-0020
- **Mailing address fax:** (970) 348-0055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 04/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04007357 | — | CO |