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Organization
LAKES REGION ARTIFICIAL LIMB AND BRACE COMPANY INC
Active
Organization
LAKES REGION ARTIFICIAL LIMB AND BRACE COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MARVIN HEIDE CPO (PRESIDENT)
(218) 486-1963
Entity
Organization
Contact information
Practice address
710 VALLEY ST, HAWLEY, MN 56549
(218) 486-1963
Mailing address
710 VALLEY ST, HAWLEY, MN 56549
(218) 486-1963
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
04/01/2006
Last updated
10/30/2007
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