Individual
JACALYNN L LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
(605) 882-7636
Mailing address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
(605) 882-7636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1324
SD
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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