ELYSE E LAKE

WEST JORDAN, UT
NPI1063721611
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  6168554-8900)
Enumeration Date2010-09-30
Last Update Date2016-12-05
Business Address
-- ELYSE E LAKE N.P.
3354 W 7800 S
WEST JORDAN, UT 84088-4506
Phone number: 801-282-2677
Mailing Address
-- ELYSE E LAKE N.P.
3534 S 6000 W
WEST VALLEY CITY, UT 84128-2610
Phone number: 801-282-2677
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