Organization
FRONT RANGE FOOT AND ANKLE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL MALLETT DPM (OWNER)
(720) 670-0544
Entity
Organization
Contact information
Practice address
10259 SOUTH PARKER RD, SUITE 200A, PARKER, CO 80134
(720) 670-0544
(720) 253-0794
Mailing address
10259 SOUTH PARKER RD, SUITE 200A, PARKER, CO 80134
(720) 670-0544
(720) 253-0794
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
650
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6910950001
DMERC PTAN
CO
Enumeration date
11/03/2011
Last updated
06/09/2014
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