| NPI | 1104000900 |
|---|---|
| Doing Business As | LAKE PODIATRY |
| Entity Type | Organization |
| Authorized Contact | ATTA ASEF Owner 440-953-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OH 36002887A) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2008-05-12 |