| NPI | 1124255278 |
|---|---|
| Doing Business As | LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY |
| Entity Type | Organization |
| Authorized Contact | RICHARD D CICERO Sr. VP, Business Development 440-354-1739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2011-04-25 |