Provider Demographics
NPI:1205339959
Name:BITFOOT CO
Entity type:Organization
Organization Name:BITFOOT CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:HULSEBOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:414-897-3543
Mailing Address - Street 1:1850 E SAHARA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3746
Mailing Address - Country:US
Mailing Address - Phone:702-551-7199
Mailing Address - Fax:702-850-2965
Practice Address - Street 1:1850 E SAHARA AVE STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3746
Practice Address - Country:US
Practice Address - Phone:702-551-7199
Practice Address - Fax:702-850-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2021213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty