North Star Podiatric Lab, Inc.

NPI #1962409995 in Hugo, Minnesota

Provider Information

NPI Number
1962409995
Entity Type
Organization
Organization Name
North Star Podiatric Lab, Inc.
Primary Specialty
Prosthetic/Orthotic Supplier
Enumeration Date
Jul 5, 2005
Last Updated
May 11, 2020

Practice Location

Address
13419 FENWAY BLVD N
Address 2
SUITE 101
City
Hugo
ZIP Code
55038-7465
Phone
(651) 426-9388

Authorized Official

Name
MRS. TERRI WAGNER, CP
Title
CERTIFIED PEDORTHIST
Phone
(651) 426-9388

Specialties & Taxonomy Codes

Specialty
Prosthetic/Orthotic Supplier

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