Individual
HEATHER M LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
285 E STATE ST, SUITE 620, COLUMBUS, OH 43215-4354
(614) 566-9380
(614) 566-8175
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
34009625
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2966714
—
OH
Enumeration date
04/04/2007
Last updated
01/05/2022
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