Lacey Jo Lake

NPI #1043624083 in Muscatine, Iowa

Provider Information

NPI Number: 1043624083
Entity Type: Individual
Name: Lacey Jo Lake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Radiologic Technologist
Enumeration Date: Jun 18, 2014
Last Updated: Jun 18, 2014

Practice Location

Address: 2114 PINEFIELD ST
City: Muscatine
State: Iowa
ZIP Code: 52761-2553
Phone: (563) 607-2372

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Radiologic Technologist	247100000X	Primary

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