| NPI | 1760884399 |
|---|---|
| Doing Business As | LAKE PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | PATRICK T BOYLAN Owner / Physician 440-205-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35072046) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2020-03-02 |