Organization
FOREST LAKE SKIN AND VEIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESA RENAE STEGNER CNP (PRESIDENT)
(651) 464-7273
Entity
Organization
Contact information
Practice address
280 12TH ST SW, SUITE A, FOREST LAKE, MN 55025-3778
(651) 464-7273
(651) 464-7969
Mailing address
280 12TH ST SW, SUITE A, FOREST LAKE, MN 55025-3778
(651) 464-7273
(651) 464-7969
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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