Individual
MRS. MARGARET J LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NBC-HIS
Contact information
Practice address
1640 W LOCUST ST, DAVENPORT, IA 52804-3636
(563) 326-5441
(563) 326-5441
Mailing address
1640 W LOCUST ST, DAVENPORT, IA 52804-3636
(563) 326-5441
(563) 326-5441
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
350
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0259606
—
IA
05
—
0935718
—
IA
Enumeration date
10/27/2006
Last updated
07/09/2007
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