KENNETH DOUGLAS LAKE

ASHEBORO, NC
NPI1518981927
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  101208)
Enumeration Date2006-07-27
Last Update Date2019-02-04
Business Address
MR. KENNETH DOUGLAS LAKE PA-C
300 MACK RD
ASHEBORO, NC 27205-1066
Phone number: 336-625-1172
Mailing Address
MR. KENNETH DOUGLAS LAKE PA-C
PO BOX 2005
ASHEBORO, NC 27204-2005
Phone number: 336-625-1172
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