Individual
MR. TODD MICHAEL WESTLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
606 24TH AVE S, SUITE 301, MINNEAPOLIS, MN 55454-1455
(612) 672-6653
(612) 672-4780
Mailing address
22990 FAWN TRL, ROGERS, MN 55374-8740
(763) 428-5453
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO 1904
MN
224P00000X
Prosthetist
CPO 1904
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077842
FAIRVIEW HEATH SERVICES #
MN
Enumeration date
05/02/2007
Last updated
01/26/2012
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