Healthcare Provider Details
I. General information
NPI: 1811798747
Provider Name (Legal Business Name): NEXT STEP FOOT AND ANKLE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11709 OLD BALLAS RD STE 201
CREVE COEUR MO
63141-7029
US
IV. Provider business mailing address
PO BOX 825159
PHILADELPHIA PA
19182-5159
US
V. Phone/Fax
- Phone: 314-432-1903
- Fax: 314-432-5105
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSALIE
KREIGHBAUM
Title or Position: REGIONAL CREDENTIALING SPECIALIST
Credential:
Phone: 314-909-1920