| NPI | 1710207329 |
|---|---|
| Doing Business As | LAKE HEALTH PHYSICIAN GROUP OB/GYN |
| Entity Type | Organization |
| Authorized Contact | ROBERT B TRACZ Chief Financial Officer 440-354-1642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |