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Organization

WHITE BEAR FOOT AND ANKLE CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER M PHILLIPS DPM (OWNER)
(651) 426-3995
Entity
Organization

Contact information

Practice address
4653 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3300
(651) 426-3995
(651) 426-5626
Mailing address
4653 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3300
(651) 426-3995
(651) 426-5626

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
472603200
MN
Enumeration date
03/26/2014
Last updated
11/13/2014
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