RONALD LAKE

PRESCOTT, AZ
NPI1255721684
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy174400000X Specialist
(Licence: CA  11388927)
Enumeration Date2015-01-22
Last Update Date2015-01-22
Business Address
Mr. RONALD LAKE C.Ht.
807 LIZZARD LN
PRESCOTT, AZ 86303-4517
Phone number: 800-541-9928
Mailing Address
Mr. RONALD LAKE C.Ht.
807 LIZZARD LN
PRESCOTT, AZ 86303-4517
Phone number: 800-541-9928
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