Provider Demographics
NPI:1659831238
Name:FOOT AND ANKLE CENTER OF THE ROCKIES LLC
Entity Type:Organization
Organization Name:FOOT AND ANKLE CENTER OF THE ROCKIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KORELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-590-1399
Mailing Address - Street 1:4600 HALE PKWY STE 440
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4000
Mailing Address - Country:US
Mailing Address - Phone:303-321-4477
Mailing Address - Fax:303-321-5323
Practice Address - Street 1:4600 HALE PKWY STE 440
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4000
Practice Address - Country:US
Practice Address - Phone:303-321-4477
Practice Address - Fax:303-321-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty