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Organization
LAKES IMAGING LLC
Active
Organization
LAKES IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOLMEN M.D. (PRESIDENT)
(218) 822-4242
Entity
Organization
Contact information
Practice address
2019 S 6TH ST, BRAINERD, MN 56401-4528
(218) 822-4242
(218) 822-3758
Mailing address
2019 S 6TH ST, BRAINERD, MN 56401-4528
(218) 822-4242
(218) 822-3758
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033922
PREFFERED ONE
MN
01
—
171008
UCARE
MN
Enumeration date
07/09/2006
Last updated
08/22/2020
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