Individual
DR. JASON S. LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
601 E RUSSELL AVE, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Mailing address
601 E RUSSELL AVE, 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
05/22/2006
Last updated
11/21/2013
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