NPI | 1407009483 |
---|---|
Entity Type | Organization |
Authorized Contact | GUY JASON WERKHOVEN President 651-423-0263 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 763) |
Enumeration Date | 2008-11-04 |
Last Update Date | 2008-11-04 |