Individual
JAKE MICHAEL LAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3702 BIRCHMERE CT, OWINGS MILLS, MD 21117-1256
(443) 814-0476
Mailing address
3702 BIRCHMERE CT, OWINGS MILLS, MD 21117-1256
(443) 814-0476
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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