MITCHELL JOHN FOGAL

WACONIA, MN
NPI1407101538
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: MN  11173)
Enumeration Date2012-07-15
Last Update Date2013-01-22
Business Address
Mr. MITCHELL JOHN FOGAL PA-C
560 S MAPLE ST STE 200 SUITE 200
WACONIA, MN 55387-1757
Phone number: 952-442-2163
Mailing Address
Mr. MITCHELL JOHN FOGAL PA-C
4200 DAHLBERG DR STE 300 SUITE 300
GOLDEN VALLEY, MN 55422-4841
Phone number: 952-512-5637