Provider Demographics
NPI:1316100290
Name:HEEL TO TOE PODIATRY LLC
Entity type:Organization
Organization Name:HEEL TO TOE PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:636-928-4447
Mailing Address - Street 1:1475 KISKER RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8781
Mailing Address - Country:US
Mailing Address - Phone:636-928-4447
Mailing Address - Fax:636-928-4497
Practice Address - Street 1:1475 KISKER RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-8781
Practice Address - Country:US
Practice Address - Phone:636-928-4447
Practice Address - Fax:636-928-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000758213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU66550Medicare UPIN