Provider Demographics
NPI:1902157704
Name:JOSEPH RIEGER
Entity Type:Organization
Organization Name:JOSEPH RIEGER
Other - Org Name:DBA A STEP AHEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:615-383-0048
Mailing Address - Street 1:718 THOMPSON LN STE 115
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3612
Mailing Address - Country:US
Mailing Address - Phone:615-383-0048
Mailing Address - Fax:
Practice Address - Street 1:237 DOVER RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4155
Practice Address - Country:US
Practice Address - Phone:615-383-0048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000184335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454962Medicaid
TN6354220001Medicare NSC