JON M LAKE

JACKSON, MI
NPI1376561696
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MI  4301068180)
Enumeration Date2006-07-17
Last Update Date2021-02-17
Business Address
JON M LAKE M.D.
400 HINCKLEY BLVD SUITE 100
JACKSON, MI 49203-6125
Phone number: 517-784-0588
Mailing Address
JON M LAKE M.D.
PO BOX 67000 DEPARTMENT 272801
DETROIT, MI 48267-0002
Phone number: 517-784-0588
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