| Park-lake Clinic | |
|
701 E Lake St Minneapolis MN 55407-1515 | |
| (612) 226-7112 | |
| Not Available |
| Full Name | Park-lake Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 701 E Lake St, Minneapolis, Minnesota |
| Authorized Official Name and Position | John R. Lundstrom (OWNER/PRESIDENT) |
| Authorized Official Contact | 6512351403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park-lake Clinic 701 E. Lake St. Minneapolis MN 55407 Ph: (612) 226-7112 | Park-lake Clinic 701 E Lake St Minneapolis MN 55407-1515 Ph: (612) 226-7112 |
| NPI Number | 1972830891 |
|---|---|
| Provider Enumeration Date | 11/13/2009 |
| Last Update Date | 11/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972830891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2261 (Minnesota) | Primary |
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