Organization
LAKE REGION THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MICHELLE MANNING OTR L (OWNER PRESIDENT)
(218) 844-5555
Entity
Organization
Contact information
Practice address
803 ROOSEVELT AVE, SUITE 301, DETROIT LAKES, MN 56501-3744
(218) 844-5555
(218) 844-6057
Mailing address
803 ROOSEVELT AVE, SUITE 301, DETROIT LAKES, MN 56501-3744
(218) 844-5555
(218) 844-6057
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
9552335
MN
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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