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NPI Code Detail

MEDICARE: GOFEET ORTHOTICS LLC

MEDICARE: GOFEET ORTHOTICS 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
1335E00000XProsthetic/Orthotic Supplier
2222Z00000XOrthotist

General Provider Information

NPI Number : 1356814248
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOFEET ORTHOTICS LLC
Provider Business Mailing Address
First Line : 315 LOOPER RD
Second Line :
City : PELZER
State : SC
Zip : 29669-1042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 103 CLAIR DR STE B
Second Line :
City : PIEDMONT
State : SC
Zip : 29673-6401
Country : US
Telephone Number : 864-252-4377
Fax Number :
Authorized Official
Title or Position : OWNER/CERTIFIED ORTHOTIST
Name : JONATHAN DANIEL WHITTEN
Credential : BOCO
Telephone Number : 864-252-4377
Provider Enumeration Date : 01/03/2019
Last Update Date : 12/11/2025

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Directions to “GOFEET ORTHOTICS LLC ” Practice Location

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