Organization
RANGE PODIATRIC CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN TYLER GARNER DPM (OWNER)
(218) 744-1961
Entity
Organization
Contact information
Practice address
809 N 6TH AVE, NORTHGATE PLAZA, VIRGINIA, MN 55792-2308
(218) 749-3818
(218) 749-3874
Mailing address
2302 HIGHWAY 53, EVELETH, MN 55734-8523
(218) 744-1961
(218) 744-1961
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
774
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480000590
—
MN
Enumeration date
04/02/2007
Last updated
10/28/2011
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