# RIO GRANDE FOOT & ANKLE SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIO GRANDE FOOT & ANKLE SPECIALISTS LLC
- **Other names:** Rio Grande Foot & Ankle Specialists LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497364780
- **Legal business name:** RIO GRANDE FOOT & ANKLE SPECIALISTS LLC
- **Authorized official:** MICHELLE ELIZABETH DEITHLOFF (DPM/OWNER)
- **Authorized official phone:** (505) 395-9575

## Contact information

- **Practice address:** 2019 GALISTEO ST STE K-2, SANTA FE, NM 87505-2143
- **Practice address phone:** (505) 395-9575
- **Practice address fax:** (877) 540-1253
- **Mailing address:** PO BOX 540610, N SALT LAKE, UT 84054-0610
- **Mailing address phone:** (801) 505-0821
- **Mailing address fax:** (801) 505-0803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2020
- **Last updated:** 06/13/2022