Provider Demographics
NPI:1619354305
Name:MUGAAS, BOBBI JO (CO)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JO
Last Name:MUGAAS
Suffix:
Gender:F
Credentials:CO
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Mailing Address - Street 1:360 SHERMAN ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2564
Mailing Address - Country:US
Mailing Address - Phone:651-291-9000
Mailing Address - Fax:651-291-8894
Practice Address - Street 1:360 SHERMAN ST
Practice Address - Street 2:SUITE 160
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2564
Practice Address - Country:US
Practice Address - Phone:651-291-9000
Practice Address - Fax:651-291-8894
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist