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Organization
NORTHERN LAKES SURGERY CENTER LLC
Active
Organization
NORTHERN LAKES SURGERY CENTER LLC
Active
Other names
NORTHERN LAKES SURGERY CENTER LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LORI PECK (SVP- CHIEF FINANCIAL OFFICER)
(715) 847-2575
Entity
Organization
Contact information
Practice address
4791 COUNTY ROAD 10, MOOSE LAKE, MN 55767-9221
(218) 249-5555
Mailing address
915 E 1ST ST, DULUTH, MN 55805-2107
(218) 249-5555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
03/11/2026
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