Individual
JEFFREY CRAIG PELLERSELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
563 BIELENBERG DR, SUITE 150, WOODBURY, MN 55125-4425
(651) 457-4665
(651) 457-3115
Mailing address
563 BIELENBERG DR, SUITE 150, WOODBURY, MN 55125-4425
(651) 457-4665
(651) 457-3115
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
473
MN
213E00000X
Podiatrist
668-025
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
473
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
668-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43214500
—
WI
05
—
944325800
—
MN
Enumeration date
05/23/2006
Last updated
02/23/2009
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