| NPI | 1154701803 |
|---|---|
| Other Name | LAKE REGIONAL EAR, NOSE AND THROAT |
| Entity Type | Organization |
| Authorized Contact | MICHAEL E. HENZE President 573-348-8392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |