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General NPI Number Information
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NPI Number | 1154382398
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Entity Type | Organization
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Legal Business Name | ELK RIVER FOOT & ANKLE CLINIC PA
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 554 3RD ST NW SUITE 201
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City | ELK RIVER
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State | MN
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Zip | 55330
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Country | US
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Telephone | 763-241-4036
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Fax | 763-274-1511
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Provider Business Mailing Address
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Address Line | 554 3RD ST NW SUITE 201
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City | ELK RIVER
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State | MN
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Zip | 55330
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Country | US
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Telephone | 763-241-4036
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Fax | 763-274-1511
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSEPH PAUL SCHUSTER
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Credential | DPM
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Telephone | 763-241-4036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 597
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License Number State | MN
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