| NPI | 1629244686 |
|---|---|
| Doing Business As | LAKEVILLE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | MARK S. MELLSTROM Owner 952-469-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 6208286) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |