Organization
LAKE REGION HEALTHCARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT MATTSON (CEO)
(218) 736-8090
Entity
Organization
Contact information
Practice address
111 W VERNON AVE, FERGUS FALLS, MN 56537-2741
(218) 736-8000
Mailing address
712 S CASCADE ST, FERGUS FALLS, MN 56537-2913
(218) 736-8000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1783
MN
332H00000X
Eyewear Supplier
1783
MN
Other
Enumeration date
11/02/2015
Last updated
08/19/2024
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