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1992900336
JIMMA LANELLE LAKE
WAXAHACHIE, TX
NPI
1992900336
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TX 2012555)
Enumeration Date
2007-06-17
Last Update Date
2007-07-08
Business Address
MRS. JIMMA LANELLE LAKE LPTA
112 VINTAGE DR
WAXAHACHIE, TX 75165-6510
Phone number: 214-632-9075
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Mailing Address
MRS. JIMMA LANELLE LAKE LPTA
PO BOX 81
RICHLAND, TX 76681-0081
Phone number: 903-362-4012
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