Organization
SALLY A SERVOLD DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY A SERVOLD DPM (PRESIDENT)
(970) 928-9785
Entity
Organization
Contact information
Practice address
401 23RD ST, SUITE 205, GLENWOOD SPRINGS, CO 81601-4363
(970) 928-9785
(970) 928-0423
Mailing address
401 23RD ST, SUITE 205, GLENWOOD SPRINGS, CO 81601-4363
(970) 928-9785
(970) 928-0423
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
0459
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01004597
—
CO
01
—
0459
STATE LIC
CO
Enumeration date
02/21/2008
Last updated
03/07/2023
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