Organization
LAKES ORTHOTICS & PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH EDWARD PERRY CPO (VICE PRESIDENT)
(952) 745-3004
Entity
Organization
Contact information
Practice address
14395 23RD AVE N, PLYMOUTH, MN 55447-4704
(952) 745-3004
(952) 745-3010
Mailing address
14395 23RD AVE N, PLYMOUTH, MN 55447-4704
(952) 745-3004
(952) 745-3010
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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