NPI 1245975614 · live from the CMS NPI Registry
Basso Family LLC
Podiatrist in Saint Louis, MO. National Provider Identifier 1245975614, active.
NPI record
| NPI | 1245975614 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 2821 N Ballas Rd Ste C15, Saint Louis, MO 63131 |
| Practice phone | 314-394-8580 |
| Mailing address | 4105 Endicott Ct, Swansea, IL 62226 |
| Enumerated | April 30, 2022 |
| Last updated | November 6, 2023 |
| Authorized official | Douglas Basso, Chief Officer |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.