| NPI | 1245278936 |
|---|---|
| Doing Business As | ESSENTIA HEALTH LAKESIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KEVIN BOREN VP Of Finance 218-786-1009 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-02-28 |