| NPI | 1003012279 |
|---|---|
| Doing Business As | LAKE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MELCHOR SIPALAY Owner 719-564-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 38338) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2008-05-16 |