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Individual

NICHOLAS STAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6625 LYNDALE AVE S STE 105, RICHFIELD, MN 55423-2673
(612) 200-8029
Mailing address
6625 LYNDALE AVE S STE 300, RICHFIELD, MN 55423-2491
(612) 788-8778
(612) 869-3473

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1091
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/02/2018
Last updated
08/23/2021
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