Provider Demographics
NPI:1376524991
Name:PERFECT FEET INC
Entity Type:Organization
Organization Name:PERFECT FEET INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:KEN
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-710-7347
Mailing Address - Street 1:5728 S 1475 E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4833
Mailing Address - Country:US
Mailing Address - Phone:801-710-7347
Mailing Address - Fax:801-479-4577
Practice Address - Street 1:5728 S 1475 E
Practice Address - Street 2:SUITE 102
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4833
Practice Address - Country:US
Practice Address - Phone:801-710-7347
Practice Address - Fax:801-479-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid
UT=========001Medicaid