SHANE MICHAEL LAKE

BETHEL, AK
NPI1588135008
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2018-12-10
Last Update Date2018-12-10
Business Address
SHANE MICHAEL LAKE
829 CHIEF EDDIE HOFFMAN HWY
BETHEL, AK 99559
Phone number: 907-543-6100
Mailing Address
SHANE MICHAEL LAKE
PO BOX 528
BETHEL, AK 99559-0528
Phone number: 907-543-6552
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