Healthcare Provider Details

I. General information

NPI: 1790970762
Provider Name (Legal Business Name): FOOTTENDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 E GIRARD AVE SUITE 4350
AURORA CO
80014-3988
US

IV. Provider business mailing address

15200 E GIRARD AVE SUITE 4350
AURORA CO
80014-3988
US

V. Phone/Fax

Practice location:
  • Phone: 303-841-9270
  • Fax: 303-991-6032
Mailing address:
  • Phone: 303-841-9270
  • Fax: 303-991-6032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY SCHMIDT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 303-841-9270