Healthcare Provider Details

I. General information

NPI: 1669858700
Provider Name (Legal Business Name): NEX STEP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 OLD SANTA FE TRL SUITE 1, PMB 220
SANTA FE NM
87505-0398
US

IV. Provider business mailing address

518 OLD SANTA FE TRL SUITE 1, PMB 220
SANTA FE NM
87505-0398
US

V. Phone/Fax

Practice location:
  • Phone: 505-501-2038
  • Fax:
Mailing address:
  • Phone: 505-501-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM AL BRUNS
Title or Position: PRESIDENT/CEO
Credential: D.C.
Phone: 505-501-2038