Organization
ACTIVE FEET , FOOT & ANKLE HEALTH CENTER
Active
Other names
Midwest Podiatry Centers Cottage Grove
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN MOHR DPM (OWNER)
(612) 798-0170
Entity
Organization
Contact information
Practice address
7501 80TH ST S, COTTAGE GROVE, MN 55016-3020
(651) 459-9171
Mailing address
7430 80TH ST S, SUITE 104, COTTAGE GROVE, MN 55016-3035
(612) 788-8778
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
631
MN
Other
Enumeration date
06/02/2011
Last updated
11/15/2012
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