Healthcare Provider Details

I. General information

NPI: 1649711524
Provider Name (Legal Business Name): DARE FOOT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 GLENN HENDREN DR
LIBERTY MO
64068-3375
US

IV. Provider business mailing address

6209 MID RIVERS MALL DR SUITE 320
SAINT PETERS MO
63304-1102
US

V. Phone/Fax

Practice location:
  • Phone: 816-736-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS GAEFKE
Title or Position: OWNER
Credential: DPM
Phone: 816-804-9642