Individual
MR. BRYAN MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6625 LYNDALE AVE S STE 105, RICHFIELD, MN 55423-2673
(612) 788-8778
(612) 869-3473
Mailing address
6625 LYNDALE AVE S STE 300, RICHFIELD, MN 55423-2491
(612) 788-8778
(612) 869-3473
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1164-25
WI
213E00000X
Podiatrist
Primary
631
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124307
UCARE
MN
05
—
148473700
—
MN
01
—
54B22MO
BLUE CROSS
MN
01
—
HP30542
HEALTH PARTNERS
MN
Enumeration date
06/20/2005
Last updated
04/29/2020
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