Organization
RIO GRANDE FOOT & ANKLE SPECIALISTS, LLC
Active
Parent organization
RIO GRANDE FOOT & ANKLE SPECIALISTS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIO GRANDE FOOT & ANKLE SPECIALISTS, LLC
Authorized official
MICHELLE ELIZABETH DEITHLOFF (DPM/OWNER)
(505) 395-9575
Entity
Organization
Contact information
Practice address
404 BRUNN SCHOOL RD, SANTA FE, NM 87505-1102
(505) 395-9575
(877) 540-1253
Mailing address
280 S MAIN ST, BOUNTIFUL, UT 84010-6236
(801) 505-0821
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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