Individual
RANDY LEN LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13965 MOSSY STONE WAY, EDMOND, OK 73025-5024
(405) 204-3389
Mailing address
13965 MOSSY STONE WAY, EDMOND, OK 73025-5024
(405) 204-3389
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/09/2013
Last updated
06/18/2025
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