Mountain Lake Wellness LLC

NPI #1700603008 in Oakland, Maryland

Provider Information

NPI Number: 1700603008
Entity Type: Organization
Organization Name: Mountain Lake Wellness LLC
Primary Specialty: Nurse Practitioner
Enumeration Date: Sep 26, 2024
Last Updated: Sep 26, 2024

Practice Location

Address: 257 OAKLAND DR STE 103
City: Oakland
State: Maryland
ZIP Code: 21550-3228
Phone: (240) 284-5696

Authorized Official

Name: JAMES LUKAS, CRNP
Title: OWNER
Phone: (240) 284-5696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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