Organization
LAKE PROSTHETICS AND RESEARCH, LLC
Active
Organization
LAKE PROSTHETICS AND RESEARCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH CHRISTOPHER LAKE L/CPO, FAAOP (CHIEF CLINICAL DIRECTOR)
(817) 358-1500
Entity
Organization
Contact information
Practice address
350 WESTPARK WAY, SUITE 108, EULESS, TX 76040-3964
(817) 358-1500
(682) 224-8430
Mailing address
350 WESTPARK WAY, SUITE 108, EULESS, TX 76040-3964
(817) 358-1500
(682) 224-8430
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
80
TX
Other
Enumeration date
04/06/2011
Last updated
08/31/2011
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