Provider Demographics
NPI:1215415195
Name:FOOT OF THE MOUNTAINS PLLC
Entity Type:Organization
Organization Name:FOOT OF THE MOUNTAINS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-482-3668
Mailing Address - Street 1:608 E HARMONY RD STE 301
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3210
Mailing Address - Country:US
Mailing Address - Phone:970-482-3668
Mailing Address - Fax:970-482-9078
Practice Address - Street 1:608 E HARMONY RD STE 301
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3210
Practice Address - Country:US
Practice Address - Phone:970-482-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric