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1508155870
JOSEPH CHRISTOPHER LAKE
EULESS, TX
NPI
1508155870
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224P00000X Prosthetist
(Licence: TX 80)
Additional Taxonomies
222Z00000X Orthotist
(Licence: TX 80)
Enumeration Date
2011-04-07
Last Update Date
2011-09-01
Business Address
MR. JOSEPH CHRISTOPHER LAKE L/CPO, FAAOP
350 WESTPARK WAY SUITE 108
EULESS, TX 76040-3964
Phone number: 817-358-1500
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Mailing Address
MR. JOSEPH CHRISTOPHER LAKE L/CPO, FAAOP
350 WESTPARK WAY SUITE 108
EULESS, TX 76040-3964
Phone number: 817-358-1500
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