| NPI | 1770026643 |
|---|---|
| Doing Business As | LAKES FAMILY EYECARE |
| Entity Type | Organization |
| Authorized Contact | COREY L BECKER President 218-346-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2951) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |