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Individual

DR. AUSTIN MICHAEL LAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
4681 W 20TH ST UNIT 202B, GREELEY, CO 80634
(720) 331-3687
Mailing address
2212 34TH AVE, GREELEY, CO 80634-7547
(720) 331-3687

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14911
CO

Other

Enumeration date
05/02/2018
Last updated
03/04/2020
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