| NPI | 1669759866 |
|---|---|
| Other Name | LAKEWOOD DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | JOSEPH T REYCRAFT CFO 218-894-8194 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2025-06-09 |