Individual
MR. JOSEPH CHRISTOPHER LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L/CPO, FAAOP
Contact information
Practice address
350 WESTPARK WAY, SUITE 108, EULESS, TX 76040-3964
(817) 358-1500
(682) 224-8430
Mailing address
350 WESTPARK WAY, SUITE 108, EULESS, TX 76040-3964
(817) 358-1500
(682) 224-8430
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
80
TX
224P00000X
Prosthetist
Primary
80
TX
Other
Enumeration date
04/07/2011
Last updated
09/01/2011
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