Provider Demographics
NPI:1609040393
Name:LSTEP FOOTSOLUTIONS
Entity Type:Organization
Organization Name:LSTEP FOOTSOLUTIONS
Other - Org Name:APPLE VALLEY FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PETERKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-423-3338
Mailing Address - Street 1:15594 PILOT KNOB RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7295
Mailing Address - Country:US
Mailing Address - Phone:952-423-3338
Mailing Address - Fax:
Practice Address - Street 1:15594 PILOT KNOB RD
Practice Address - Street 2:SUITE 400
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7295
Practice Address - Country:US
Practice Address - Phone:952-423-3338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6181210001Medicare NSC