Active Feet LLC

NPI #1750686747 in Edina, Minnesota

Provider Information

NPI Number: 1750686747
Entity Type: Organization
Organization Name: Active Feet LLC
Primary Specialty: Clinic/Center - Podiatric
Enumeration Date: Jan 21, 2011
Last Updated: Feb 25, 2011

Practice Location

Address: 7250 FRANCE AVE S
Address 2: SUITE 415
City: Edina
State: Minnesota
ZIP Code: 55435-4305
Phone: (952) 926-3566

Authorized Official

Name: DR. STACEY LEE WHITE, DPM
Title: OWNER
Phone: (612) 240-6028

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Podiatric — Podiatric	261QP1100X	Primary

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