Organization · Type 2 NPI
Lost Lake Optical Company
Clinic/Center · Mound, MN
NPI number
1003434622
Active
Practice location
5240 Shady Island Cir
Mound, MN 55364-9222
Fax (952) 474-1933
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | None listed |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
About NPI 1003434622
Lost Lake Optical Company's National Provider Identifier is 1003434622, issued on Jul 9, 2020. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Mound, MN. The record was last updated on Sep 4, 2020.