Healthcare Provider Details

I. General information

NPI: 1821034927
Provider Name (Legal Business Name): KYMBERLY JUNE VOGT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KYMBERLY JUNE LEHENBAUER

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DELLWOOD ST S
CAMBRIDGE MN
55008-1920
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 763-689-7700
  • Fax:
Mailing address:
  • Phone: 612-262-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number758
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number758
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number758
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: