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General NPI Number Information
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NPI Number | 1699116350
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Entity Type | Organization
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Legal Business Name | 1ST STEP FAMILY WELLNESS, LLC
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 439 S KIRKWOOD RD SUITE 214
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6169
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Country | US
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Telephone | 314-805-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 439 S KIRKWOOD RD SUITE 214
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6169
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Country | US
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Telephone | 314-805-7837
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. RYAN ALLEN SANDHEINRICH
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Credential | D.C.
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Telephone | 314-805-7837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2011012882
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License Number State | MO
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