Organization Name: | ACTIVE FEET , FOOT & ANKLE HEALTH CENTER |
NPI Number: | 1932493350 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRYAN MOHR (OWNER) |
Mailing Address: | 7501 80th St S Cottage Grove |
State: | MN US |
Postal Code: | 550163020 |
Phone Number: | 6514599171 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2011 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 631 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |