Individual
MARK LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1767 HAMPTON KNOLL DR, AKRON, OH 44313-4878
(330) 972-7503
Mailing address
1767 HAMPTON KNOLL DR, AKRON, OH 44313-4878
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002955
OH
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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