Healthcare Provider Details

I. General information

NPI: 1265218556
Provider Name (Legal Business Name): FOOTCARE 2 U LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 09/04/2023
Certification Date: 09/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 GRAND MONTECITO PKWY # B
LAS VEGAS NV
89149-0260
US

IV. Provider business mailing address

9811 W CHARLESTON BLVD # 2-859
LAS VEGAS NV
89117-7528
US

V. Phone/Fax

Practice location:
  • Phone: 702-525-7320
  • Fax: 866-691-8994
Mailing address:
  • Phone: 702-525-7320
  • Fax: 866-691-8994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC JAYSON ZANG
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 702-525-7320