# LAKES ORTHOTICS & PROSTHETICS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316488307
- **Authorized official:** MR. JOSEPH EDWARD PERRY CPO (VICE PRESIDENT)
- **Authorized official phone:** (952) 745-3004

## Contact information

- **Practice address:** 14395 23RD AVE N, PLYMOUTH, MN 55447-4704
- **Practice address phone:** (952) 745-3004
- **Practice address fax:** (952) 745-3010
- **Mailing address:** 14395 23RD AVE N, PLYMOUTH, MN 55447-4704
- **Mailing address phone:** (952) 745-3004
- **Mailing address fax:** (952) 745-3010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 03/10/2017
- **Last updated:** 03/10/2017