JEREMY WILLIAM LAKE

CEDAR CITY, UT
NPI1770802431
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2010-05-20
Last Update Date2010-05-20
Business Address
-- JEREMY WILLIAM LAKE
6484 N 2300 W
CEDAR CITY, UT 84721-7102
Phone number: 435-867-4876
Mailing Address
-- JEREMY WILLIAM LAKE
6484 N. 2300 W.
CEDAR CITY, UT 84721
Phone number: 435-867-4876