Organization
LAKEVIEW MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH J OLSON MD (PRESIDENT)
(320) 352-6591
Entity
Organization
Contact information
Practice address
433 ELM ST N, SAUK CENTRE, MN 56378-1052
(320) 352-6591
Mailing address
433 ELM STREET NORTH, SAUK CENTRE, MN 56378
(320) 352-6591
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54033LA
BCBS OF MN
MN
Enumeration date
03/19/2007
Last updated
12/19/2007
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