Organization
FOOTHILLS ORTHOPEDIC & SPORT THERAPY, PC
Active
Parent organization
FOOTHILLS ORTHOPEDIC & SPORT THERAPY P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOOTHILLS ORTHOPEDIC & SPORT THERAPY P.C.
Authorized official
DUANE ALLEN PEDERSEN MSPT (PRACTICE MANAGER)
(970) 667-7755
Entity
Organization
Contact information
Practice address
3938 JFK PKWY UNIT 11E, FORT COLLINS, CO 80525-3087
(970) 207-1500
(970) 207-0075
Mailing address
2964 GINNALA DR, LOVELAND, CO 80538-2701
(970) 667-7755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02103354
—
CO
Enumeration date
10/22/2021
Last updated
03/08/2022
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