Lake Hospital System, Inc.

NPI #1174844724 in Mentor, Ohio

Provider Information

NPI Number: 1174844724
Entity Type: Organization
Organization Name: Lake Hospital System, Inc.
Primary Specialty: Surgery - Plastic and Reconstructive Surgery
Enumeration Date: Jun 17, 2010
Last Updated: Jun 17, 2010

Practice Location

Address: 9500 MENTOR AVE
Address 2: SUITE 200
City: Mentor
State: Ohio
ZIP Code: 44060-8713
Phone: (440) 205-5433

Authorized Official

Name: ROBERT B TRACZ
Title: CHIEF FINANCIAL OFFICER
Phone: (440) 354-1642

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery - Plastic and Reconstructive Surgery — Plastic and Reconstructive Surgery	2086S0122X	Primary

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