Provider Demographics
NPI:1033721303
Name:STRIDE FOOT AND ANKLE PLLC
Entity Type:Organization
Organization Name:STRIDE FOOT AND ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:760-889-3988
Mailing Address - Street 1:1218 N 1980 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7405
Mailing Address - Country:US
Mailing Address - Phone:760-889-3988
Mailing Address - Fax:
Practice Address - Street 1:1365 W 1250 S STE 101
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-2303
Practice Address - Country:US
Practice Address - Phone:760-889-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty