Organization
FOOT & ANKLE CLINICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY CRAIG PELLERSELS DPM (OWNER)
(651) 457-4665
Entity
Organization
Contact information
Practice address
563 BIELENBERG DR, SUITE 150, WOODBURY, MN 55125-4425
(218) 365-2570
(218) 365-2570
Mailing address
563 BIELENBERG DR, SUITE 150, WOODBURY, MN 55125-4425
(218) 365-2570
(218) 365-2570
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
473
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43214500
—
WI
05
—
43240800
—
WI
05
—
944325800
—
MN
Enumeration date
06/07/2006
Last updated
05/02/2008
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