Provider Demographics
NPI:1407009483
Name:AERO PODIATRICS, INC.
Entity Type:Organization
Organization Name:AERO PODIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:WERKHOVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-423-0263
Mailing Address - Street 1:1668 142ND CT W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-3595
Mailing Address - Country:US
Mailing Address - Phone:651-423-0263
Mailing Address - Fax:
Practice Address - Street 1:1668 142ND CT W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3595
Practice Address - Country:US
Practice Address - Phone:651-423-0263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN763213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty