Organization
ADVANCED MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACIE BAUER (MANAGER)
(619) 710-9543
Entity
Organization
Contact information
Practice address
755 QUALITY AVE N, LAKELAND, MN 55043-9613
(619) 710-9543
Mailing address
755 QUALITY AVE N, LAKELAND, MN 55043-9613
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
122300000X
Dentist
—
—
207W00000X
Ophthalmology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
231H00000X
Audiologist
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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