Organization
STEP LIVELY FOOT AND ANKLE CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA TRAN (PRACTICE ADMINISTRATOR)
(614) 304-0019
Entity
Organization
Contact information
Practice address
1045 BEECHER XING N, STE. A, GAHANNA, OH 43230-4558
(614) 304-0019
(614) 304-0023
Mailing address
1045 BEECHER XING N, SUITE A, GAHANNA, OH 43230-4558
(614) 304-0019
(614) 304-0023
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
36002316P
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36002329W
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
36002479W
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
36003204D
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
36003275L
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
36003465
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0753340
—
OH
01
—
CB1401
MEDICARE RAILROAD
OH
Enumeration date
05/04/2007
Last updated
10/07/2019
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