Organization
LAKE HOSPITAL SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TRACZ (CFO)
(440) 354-1990
Entity
Organization
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 953-6082
Mailing address
PO BOX 714031, COLUMBUS, OH 43271-4031
(440) 716-1283
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/11/2006
Last updated
08/22/2020
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