MICHAEL LAKE

SAINT LOUIS, MO
NPI1710968573
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MO  066594)
Enumeration Date2005-11-09
Last Update Date2008-07-25
Business Address
-- MICHAEL LAKE CRNA
2345 DOUGHERTY FERRY RD
SAINT LOUIS, MO 63122-3313
Phone number: 314-821-5850
Mailing Address
-- MICHAEL LAKE CRNA
13523 BARRETT PARKWAY DR SUITE 210
BALLWIN, MO 63021-3802
Phone number: 314-775-2816
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