Scott Lake, OD

NPI #1154587822 in Glendale, Arizona

Provider Information

NPI Number: 1154587822
Entity Type: Individual
Name: Scott Lake, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Aug 1, 2008
Last Updated: Sep 21, 2021

Practice Location

Address: 5707 W NORTHERN AVE STE 106
City: Glendale
State: Arizona
ZIP Code: 85301-1355
Phone: (602) 512-3299

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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