| NPI | 1447417191 |
|---|---|
| Doing Business As | LAKESHORE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DAVID GIBBONS President 814-877-7591 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2013-08-30 |