| NPI | 1174844724 |
|---|---|
| Doing Business As | LAKE HEALTH PHYSICIAN GROUP PLASTIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | ROBERT B TRACZ Chief Financial Officer 440-354-1642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |