MEDICARE: HEALTHY FEET, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		NV

General Provider Information

NPI Number	:	1215148887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY FEET, LLC.

Provider Business Mailing Address
First Line	:	3310 SIRIUS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-7822
Country	:	US
Telephone Number	:	702-221-8721
Fax Number	:	702-221-8720

Provider Business Practice Location Address
First Line	:	3310 SIRIUS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-7822
Country	:	US
Telephone Number	:	702-221-8721
Fax Number	:	702-221-8720

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. JEFF BLUTH
Credential	:
Telephone Number	:	520-548-5579

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	08/22/2020

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