Organization
ACTIVE FEET , FOOT & ANKLE HEALTH CLINIC, INC
Active
Other names
Midwest Podiatry Centers Blaine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN MOHR DPM (OWNER)
(612) 788-8778
Entity
Organization
Contact information
Practice address
11901 CENTRAL AVE NE, BLAINE, MN 55434-3911
(612) 788-8778
(612) 869-3473
Mailing address
6600 LYNDALE AVE SOUTH, SUITE 130, RICHFIELD, MN 55423-3398
(612) 788-8778
(612) 869-3473
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
06/02/2011
Last updated
11/29/2011
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