Healthcare Provider Details

I. General information

NPI: 1720207863
Provider Name (Legal Business Name): GRAND VALLEY FOOT & ANKLE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 N 8TH ST STE 206
GRAND JUNCTION CO
81501-8858
US

IV. Provider business mailing address

2530 N 8TH ST STE 206
GRAND JUNCTION CO
81501-8858
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-3338
  • Fax: 970-245-9499
Mailing address:
  • Phone: 970-245-3338
  • Fax: 970-245-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL OWENS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 970-245-3338