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General NPI Number Information
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NPI Number | 1023469608
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Entity Type | Organization
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Legal Business Name | NEXT STEP FOOT & ANKLE CENTER, LLC
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Dates
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Enumeration Date | 06/25/2016
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 158 MAIN ST
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City | PENNSBURG
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State | PA
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Zip | 18073
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Country | US
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Telephone | 215-679-5393
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Fax | 215-679-9674
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Provider Business Mailing Address
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Address Line | 158 MAIN ST
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City | PENNSBURG
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State | PA
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Zip | 18073-1312
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Country | US
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Telephone | 215-679-5393
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Fax | 215-679-9674
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Authorized Official
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Title or Position | SINGLE MANAGING MEMBER
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Name | JASON FISKE-BAIER
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Credential | DPM
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Telephone | 610-739-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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