Individual ProviderJeremy David FooterSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7138PECOS EnrollmentThis provider is enrolled in PECOS as JEREMY FOOTER.Based on the most recent information from CMS, provider Jeremy David Footer is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1740545672Provider TypeIndividualFull NameFooter, Jeremy DavidTitleMr.CredentialLCSWGenderMaleSole ProprietorNoEnumeration Date7/6/2012Last Updated12/10/2021Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxMailing LocationMailing Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense9484273-3501Utah