| NPI | 1063704807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN L MOHR Owner 612-788-7274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 631) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |