Jacalynn L Lake, PT

NPI #1639316276 in Watertown, South Dakota

Provider Information

NPI Number: 1639316276
Entity Type: Individual
Name: Jacalynn L Lake, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Jan 20, 2009
Last Updated: Jan 20, 2009

Practice Location

Address: 401 9TH AVE NW
City: Watertown
State: South Dakota
ZIP Code: 57201-1548
Phone: (605) 882-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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