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1750892675
CURTIS E LAKE
FORT WAYNE, IN
NPI
1750892675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10002398)
Enumeration Date
2017-10-18
Last Update Date
2022-10-10
Business Address
CURTIS E LAKE
11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845-1673
Phone number: 260-425-6780
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Mailing Address
CURTIS E LAKE
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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