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1871014944
DONALD LAKE
PORT HURON, MI
NPI
1871014944
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704210937)
Enumeration Date
2017-06-29
Last Update Date
2022-07-21
Business Address
DONALD LAKE FNP-C
1221 PINE GROVE AVE MCIAREN PORT HURON
PORT HURON, MI 48060
Phone number: 810-987-5000
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Mailing Address
DONALD LAKE FNP-C
1221 PINE GROVE AVE MCIAREN PORT HURON
PORT HURON, MI 48060
Phone number: 810-987-5000
Copy
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