Lakes Orthotics & Prosthetics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LAKES ORTHOTICS & PROSTHETICS INC

Practice address

14395 23Rd Ave N
Plymouth, MN 55447-4704

Phone

(952) 745-3004

Fax

(952) 745-3010

NPI assigned

Mar 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joseph Edward Perry, CPO

Title

Vice President

Phone

(952) 745-3004

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1316488307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14395 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474704",
            "telephone_number": "952-745-3004",
            "fax_number": "952-745-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14395 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474704",
            "telephone_number": "952-745-3004",
            "fax_number": "952-745-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES ORTHOTICS & PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "952-745-3004",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Taylor Ilten Lambrecht

• Prosthetic/Orthotic Supplier in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.