Individual
JULIE ANN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4353 TULLER RD STE D, DUBLIN, OH 43017-5071
(614) 764-7900
Mailing address
5055 LANGCROFT DR, HILLIARD, OH 43026-7159
(614) 777-1618
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004535
OH
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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