# ACTIVE FEET , FOOT & ANKLE HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Podiatry Centers Cottage Grove
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932493350
- **Authorized official:** DR. BRYAN MOHR DPM (OWNER)
- **Authorized official phone:** (612) 798-0170

## Contact information

- **Practice address:** 7501 80TH ST S, COTTAGE GROVE, MN 55016-3020
- **Practice address phone:** (651) 459-9171
- **Mailing address:** 7430 80TH ST S, SUITE 104, COTTAGE GROVE, MN 55016-3035
- **Mailing address phone:** (612) 788-8778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 631 | MN | — |

## Other

- **Enumeration date:** 06/02/2011
- **Last updated:** 11/15/2012