Healthcare Provider Details
I. General information
NPI: 1417436965
Provider Name (Legal Business Name): STEVEN C FRANKLIN CPED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/07/2018
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 VIKING DR STE E
VIRGINIA BEACH VA
23452-7323
US
IV. Provider business mailing address
509 VIKING DR STE E
VIRGINIA BEACH VA
23452-7323
US
V. Phone/Fax
- Phone: 757-275-8050
- Fax: 888-600-5328
- Phone: 757-275-8050
- Fax: 888-600-5328
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224L00000X |
| Taxonomy | Pedorthist |
| License Number | CPED4422 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: