Organization
FOOT AND ANKLE PHYSICIANS WEST P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY ROGER MOELLER D.P.M. (OWNER/PHYSICIAN)
(952) 934-9360
Entity
Organization
Contact information
Practice address
7770 DELL RD, SUITE 140, CHANHASSEN, MN 55317-9314
(952) 934-9360
(952) 975-0118
Mailing address
7770 DELL RD, SUITE 140, CHANHASSEN, MN 55317-9314
(952) 934-9360
(952) 975-0118
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203525100
—
MN
05
—
913525100
—
MN
Enumeration date
01/29/2007
Last updated
07/29/2011
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