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Organization
MISSOURI FOOT CARE CENTERS, INC.
Active
Organization
MISSOURI FOOT CARE CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI JEANE RUDDLE (ADMINISTRATOR)
(314) 270-3060
Entity
Organization
Contact information
Practice address
1705 CHRISTY DR, SUITE 209, JEFFERSON CITY, MO 65101-5195
(573) 634-3338
Mailing address
12430 TESSON FERRY RD # 371, SAINT LOUIS, MO 63128-2702
(314) 843-2070
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000552
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302574710
—
MO
01
—
480025443
MEDICARE RAILROAD
MO
05
—
504901406
—
MO
01
—
CJ9611
MEDICARE RAILROAD
MO
Enumeration date
02/25/2008
Last updated
08/17/2026
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