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Organization
NORTH STAR PODIATRIC LAB, INC.
Active
Organization
NORTH STAR PODIATRIC LAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI WAGNER CP (CERTIFIED PEDORTHIST)
(651) 426-9388
Entity
Organization
Contact information
Practice address
13419 FENWAY BLVD N, SUITE 101, HUGO, MN 55038-7465
(651) 426-9388
(651) 426-7450
Mailing address
13419 FENWAY BLVD N, SUITE 101, HUGO, MN 55038-7465
(651) 426-9388
(651) 426-7450
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
07/05/2005
Last updated
05/11/2020
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