Healthcare Provider Details

I. General information

NPI: 1982577193
Provider Name (Legal Business Name): FIRST STEP PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 US 31W BYP
BOWLING GREEN KY
42101-2420
US

IV. Provider business mailing address

1136 US 31W BYP
BOWLING GREEN KY
42101-2420
US

V. Phone/Fax

Practice location:
  • Phone: 270-904-6130
  • Fax: 270-904-6132
Mailing address:
  • Phone: 270-904-6130
  • Fax: 270-904-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JEREMY E HARRIS
Title or Position: PROSTHETIST
Credential: CP
Phone: 270-904-6130