Daniel Lake, MA
NPI #1316307903 in Canon City, Colorado
Provider Information
- NPI Number
- 1316307903
- Entity Type
- Individual
- Name
- Daniel Lake, MA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Credential
- MA
- Enumeration Date
- Feb 25, 2016
- Last Updated
- Feb 25, 2016
Practice Location
- Address
- 3225 INDEPENDENCE RD
- City
- Canon City
- State
- Colorado
- ZIP Code
- 81212-9380
- Phone
- (719) 275-2351
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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