Provider Demographics
NPI:1700451515
Name:SAVE YOUR SOLE FOOT AND ANKLE SPECIALISTS PC
Entity Type:Organization
Organization Name:SAVE YOUR SOLE FOOT AND ANKLE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUCKER
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:WORTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-416-9009
Mailing Address - Street 1:1927 WILMINGTON DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1220 W ASH ST UNIT A
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4611
Practice Address - Country:US
Practice Address - Phone:970-416-9009
Practice Address - Fax:970-416-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty