Provider Demographics
NPI:1649006057
Name:FOOT SYSTEMS PLUS LLC
Entity type:Organization
Organization Name:FOOT SYSTEMS PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:702-219-7126
Mailing Address - Street 1:1490 E FOREMASTER DR STE 140
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4532
Mailing Address - Country:US
Mailing Address - Phone:702-219-7126
Mailing Address - Fax:
Practice Address - Street 1:1490 E FOREMASTER DR STE 140
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4532
Practice Address - Country:US
Practice Address - Phone:702-219-7126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthistGroup - Single Specialty