Individual
KAYSE LEE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1266 ESCALANTE DR, SUITE 201, DURANGO, CO 81303
(970) 253-5303
(970) 259-3510
Mailing address
1266 ESCALANTE DR, SUITE 201, DURANGO, CO 81303
(970) 259-5303
(970) 253-3510
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
5063880-0501
UT
213E00000X
Podiatrist
Primary
POD.0000710
CO
213E00000X
Podiatrist
POD348
NM
213ES0103X
Foot & Ankle Surgery Podiatrist
348
NM
213ES0103X
Foot & Ankle Surgery Podiatrist
36.003558
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
5063880-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
710
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07501552
—
CO
Enumeration date
04/28/2009
Last updated
02/19/2026
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