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Organization
FOREST LAKE SKIN AND VEIN CLINIC
Active
Organization
FOREST LAKE SKIN AND VEIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESA RENAE STEGNER CNP (PRESIDENT)
(651) 464-7273
Entity
Organization
Contact information
Practice address
280 12TH ST SW, SUITE A, FOREST LAKE, MN 55025-3778
(651) 464-7273
(651) 464-7969
Mailing address
280 12TH ST SW, SUITE A, FOREST LAKE, MN 55025-3778
(651) 464-7273
(651) 464-7969
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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