Provider Demographics
NPI:1558168450
Name:AT HOME FOOTCARE LLC
Entity type:Organization
Organization Name:AT HOME FOOTCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:803-262-5653
Mailing Address - Street 1:262 EASTGATE DR
Mailing Address - Street 2:PMB 149
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7698
Mailing Address - Country:US
Mailing Address - Phone:803-262-5653
Mailing Address - Fax:
Practice Address - Street 1:3609 DWYER LN
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-5411
Practice Address - Country:US
Practice Address - Phone:803-262-5653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty