OrganizationActive
Land of Lakes Orthotics & Prosthetics
NPI 1790787216 · Prosthetic/Orthotic Supplier · Plymouth, MN
Land of Lakes Orthotics & Prosthetics is a Prosthetic/Orthotic Supplier organization in Plymouth, MN (NPI 1790787216).
Provider details
- NPI number
- 1790787216
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Clark Poulson, Prosthetist Orthotist(952) 745-3004
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14395 23rd Ave N
Plymouth, MN 55447-4704
Phone: (952) 745-3004
Fax: (952) 745-3010
Street-level locationGet directions
Mailing address
14395 23rd Ave N
Plymouth, MN 55447-4704
Registry dates
- Enumerated
- 2005-08-15
- Last updated
- 2011-05-26
Frequently asked questions
- What is Land of Lakes Orthotics & Prosthetics's NPI number?
- Land of Lakes Orthotics & Prosthetics's National Provider Identifier (NPI) is 1790787216, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Land of Lakes Orthotics & Prosthetics?
- Land of Lakes Orthotics & Prosthetics is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is Land of Lakes Orthotics & Prosthetics located?
- Land of Lakes Orthotics & Prosthetics's practice location on file with NPPES is 14395 23rd Ave N, Plymouth, MN 55447-4704.
- What is Land of Lakes Orthotics & Prosthetics's phone number?
- The practice phone number listed in the NPPES registry for Land of Lakes Orthotics & Prosthetics is (952) 745-3004.
- Who is the authorized official for Land of Lakes Orthotics & Prosthetics?
- The authorized official listed on Land of Lakes Orthotics & Prosthetics's NPPES record is Clark Poulson, Prosthetist Orthotist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Land of Lakes Orthotics & Prosthetics's NPI active?
- Yes — Land of Lakes Orthotics & Prosthetics's NPI (1790787216) is active in the NPPES registry as of the last update on 2011-05-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.