Individual
DR. DAN R. MOSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3231 S NATIONAL AVE, SPRINGFIELD, MO 65807-7304
(417) 888-6708
(417) 890-4143
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000644
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303353528
—
MO
Enumeration date
01/10/2007
Last updated
11/25/2008
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