Individual
MARGARET LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 ELECTRIC AVE, PORT HURON, MI 48060-6587
(810) 985-1500
Mailing address
3130 POPLAR ST, PORT HURON, MI 48060-2050
(810) 689-8049
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704252567
MI
Other
Enumeration date
12/14/2011
Last updated
08/11/2017
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