Organization Name: | AERO PODIATRICS, INC. |
NPI Number: | 1407009483 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GUY JASON WERKHOVEN (PRESIDENT) |
Mailing Address: | 1668 142nd Ct W Rosemount |
State: | MN US |
Postal Code: | 550683595 |
Phone Number: | 6514230263 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2008 |
NPI Last Update Date: | 11/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 763 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |