Organization
SANDIA FOOT AND ANKLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL REYNOLDS (CREDENTIALING SUPERVISOR)
(505) 226-1800
Entity
Organization
Contact information
Practice address
8224 LOUISIANA BLVD NE STE C, ALBUQUERQUE, NM 87113-2108
(505) 506-2503
Mailing address
8224 LOUISIANA BLVD NE STE C, ALBUQUERQUE, NM 87113-2108
(505) 506-2503
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
290
NM
Other
Enumeration date
06/09/2017
Last updated
07/21/2022
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