MEDICARE: LAKES HOLISTIC CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5831	MN

General Provider Information

NPI Number	:	1467978247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKES HOLISTIC CARE LLC

Provider Business Mailing Address
First Line	:	6337 15TH AVE S
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-1741
Country	:	US
Telephone Number	:	612-306-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-2429
Country	:	US
Telephone Number	:	612-259-7220
Fax Number	:	612-259-7373

Authorized Official
Title or Position	:	OWNER / CHIROPRACTOR
Name	:	DR. CHRISTOPHER SAMUEL PATTERSON
Credential	:	DC
Telephone Number	:	612-259-7220

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	02/17/2025

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