Individual
DR. SUSAN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
601 E RUSSELL AVE, SUITE A, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Mailing address
601 E RUSSELL AVE, SUITE A, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
T03457
MO
Other
Enumeration date
05/19/2006
Last updated
06/18/2008
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