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1770802431
JEREMY WILLIAM LAKE
CEDAR CITY, UT
NPI
1770802431
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2010-05-20
Last Update Date
2010-05-20
Business Address
JEREMY WILLIAM LAKE
6484 N 2300 W
CEDAR CITY, UT 84721-7102
Phone number: 435-867-4876
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Mailing Address
JEREMY WILLIAM LAKE
6484 N. 2300 W.
CEDAR CITY, UT 84721
Phone number: 435-867-4876
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