MEDICARE: OUT OF STEP INVESTMENTS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1437866977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUT OF STEP INVESTMENTS, INC

Provider Business Mailing Address
First Line	:	8259 PROSPECT ST
Second Line	:
City	:	MOKELUMNE HILL
State	:	CA
Zip	:	95245-9424
Country	:	US
Telephone Number	:	916-812-8812
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 E BROAD ST STE 120
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6597
Country	:	US
Telephone Number	:	916-812-8812
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, OWNER
Name	:	JEFFREY P JOHNSON
Credential	:
Telephone Number	:	916-812-8812

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	11/03/2022

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Directions to “OUT OF STEP INVESTMENTS, INC ” Practice Location

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