Organization
LAKES AREA HEALTH CENTER, PLLC
Active
Organization
LAKES AREA HEALTH CENTER, PLLC
Active
Other names
Ottomeyer Clinics, PLLC, Ottomeyer Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT PYLKAS (CHAIRMAN)
(651) 238-5558
Entity
Organization
Contact information
Practice address
1440 DUCKWOOD DR STE 200, EAGAN, MN 55122-1451
(651) 203-4673
(651) 203-5130
Mailing address
1440 DUCKWOOD DR STE 200, EAGAN, MN 55122-1451
(651) 203-4673
(651) 203-5130
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24D2153873
CLIA
—
Enumeration date
05/16/2006
Last updated
01/12/2022
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