MISS Stacy Marrie Lake

NPI #1801436027 in Escanaba, Michigan

Provider Information

NPI Number: 1801436027
Entity Type: Individual
Name: MISS Stacy Marrie Lake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Jan 15, 2020
Last Updated: Jan 15, 2020

Practice Location

Address: 1018 LUDINGTON ST
City: Escanaba
State: Michigan
ZIP Code: 49829-3541
Phone: (702) 277-1369

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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