Organization
GERDTS PODIATRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORAL GERDTS DPM (OWNER)
(641) 832-7540
Entity
Organization
Contact information
Practice address
616 N 8TH ST, OSAGE, IA 50461-1456
(641) 732-6090
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3621
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00722
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ3207
MEDICARE RAILROAD
IA
Enumeration date
07/07/2009
Last updated
01/01/2022
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