Individual
MRS. LAURIE LEE LAKE-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
140 BRIMLEY DR, FREDERICKSBURG, VA 22406-5103
(540) 752-0111
(540) 752-0393
Mailing address
221 LAUREL ST, CULPEPER, VA 22701-4037
(540) 423-5427
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001788
VA
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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