Organization
LAKE AND LAKE OPTOMETRY PC
Active
Other names
Eyecare Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON S. LAKE O.D. (DELEGATED OFFICIAL)
(660) 747-2020
Entity
Organization
Contact information
Practice address
601 E RUSSELL AVE, SUITE A, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Mailing address
601 E RUSSELL AVE, SUITE A, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO3409
MO
Other
Enumeration date
05/19/2006
Last updated
04/08/2010
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