Organization
MOUNTAIN VISTA ORTHOPAEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI MALONE (OFFICE ADMINISTRATOR)
(970) 348-0020
Entity
Organization
Contact information
Practice address
5890 W 13TH ST, 101, GREELEY, CO 80634-4816
(970) 348-0020
(970) 348-0055
Mailing address
5890 W 13TH ST, 101, GREELEY, CO 80634-4816
(970) 348-0020
(970) 348-0055
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04007357
—
CO
Enumeration date
05/22/2006
Last updated
04/17/2008
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