| NPI | 1639648348 |
|---|---|
| Doing Business As | ESSENTIA HEALTH LAKES IMAGING |
| Entity Type | Organization |
| Authorized Contact | KEVIN BOREN VP Of Finance 218-786-1009 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2024-02-27 |