Healthcare Provider Details

I. General information

NPI: 1356814248
Provider Name (Legal Business Name): GOFEET ORTHOTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CLAIR DR STE B
PIEDMONT SC
29673-6401
US

IV. Provider business mailing address

315 LOOPER RD
PELZER SC
29669-1042
US

V. Phone/Fax

Practice location:
  • Phone: 864-252-4377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN DANIEL WHITTEN
Title or Position: OWNER/CERTIFIED ORTHOTIST
Credential: BOCO
Phone: 864-252-4377