# PROSTHETIC LABORATORIES OF ROCHESTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GMS OF ROCHESTER, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427234681
- **Legal business name:** GMS OF ROCHESTER, INC.
- **Authorized official:** RANDY LACEY (CEO)
- **Authorized official phone:** (507) 536-6100

## Contact information

- **Practice address:** 1300 ANNE ST NW, BEMIDJI, MN 56601-5103
- **Practice address phone:** (218) 333-6966
- **Practice address fax:** (218) 333-6976
- **Mailing address:** 121 23RD AVE SW, ROCHESTER, MN 55902-0998
- **Mailing address phone:** (507) 281-5250
- **Mailing address fax:** (507) 288-6928

## Taxonomy

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

## Other

- **Enumeration date:** 01/17/2008
- **Last updated:** 09/17/2008