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1619014602
DAVID LAKE GORMSEN
CANTON, OH
NPI
1619014602
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207PP0204X Emergency Medicine, Pediatric Emergency Medicine
(Licence: OH 34002838)
Enumeration Date
2007-01-31
Last Update Date
2007-07-08
Business Address
Dr. DAVID LAKE GORMSEN D.O.
1320 MERCY DR NW
CANTON, OH 44708-2614
Phone number: 330-489-1074
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Mailing Address
Dr. DAVID LAKE GORMSEN D.O.
4189 SONGBIRD TRL
STOW, OH 44224-2572
Phone number: 330-688-4160
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