Provider Demographics
NPI:1992406490
Name:GENTLE FOOTCARE LLC
Entity type:Organization
Organization Name:GENTLE FOOTCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-239-9444
Mailing Address - Street 1:P.O. BOX 27940
Mailing Address - Street 2:
Mailing Address - City:COLUMBS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-0940
Mailing Address - Country:US
Mailing Address - Phone:614-885-8895
Mailing Address - Fax:614-785-6543
Practice Address - Street 1:37 E. WILSON BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2354
Practice Address - Country:US
Practice Address - Phone:614-885-8895
Practice Address - Fax:614-785-6543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric