Provider Demographics
NPI:1457467813
Name:RWL, LLC
Entity Type:Organization
Organization Name:RWL, LLC
Other - Org Name:WENTZVILLE FOOT AND ANKLE-ST CHARLES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DPM
Authorized Official - Prefix:
Authorized Official - First Name:REED
Authorized Official - Middle Name:
Authorized Official - Last Name:LUIKAART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:636-916-4842
Mailing Address - Street 1:PO BOX 411161
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-3161
Mailing Address - Country:US
Mailing Address - Phone:314-989-0300
Mailing Address - Fax:
Practice Address - Street 1:330 1ST CAPITOL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2835
Practice Address - Country:US
Practice Address - Phone:636-916-4842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000157310213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU57049Medicare UPIN