Healthcare Provider Details

I. General information

NPI: 1487935060
Provider Name (Legal Business Name): STEP AHEAD FOOT & ANKLE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 COMMONS LOOP SUITE 400
KALISPELL MT
59901-1904
US

IV. Provider business mailing address

175 COMMONS LOOP SUITE 400
KALISPELL MT
59901-1904
US

V. Phone/Fax

Practice location:
  • Phone: 406-755-2818
  • Fax: 406-755-2991
Mailing address:
  • Phone: 406-755-2818
  • Fax: 406-755-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number173
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number173
License Number StateMT

VIII. Authorized Official

Name: DR. ESTHER SUE BARNES
Title or Position: PRESIDENT
Credential: DPM
Phone: 406-755-2818