JIMMA LANELLE LAKE

WAXAHACHIE, TX
NPI1992900336
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: TX  2012555)
Enumeration Date2007-06-17
Last Update Date2007-07-08
Business Address
Mrs. JIMMA LANELLE LAKE lpta
112 VINTAGE DR
WAXAHACHIE, TX 75165-6510
Phone number: 214-632-9075
Mailing Address
Mrs. JIMMA LANELLE LAKE lpta
PO BOX 81
RICHLAND, TX 76681-0081
Phone number: 903-362-4012
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