Individual
COREY LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1924 ALCOA HWY, BOX U109, KNOXVILLE, TN 37920-1511
(865) 305-9220
Mailing address
1924 ALCOA HWY, BOX U109, KNOXVILLE, TN 37920-1511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME146259
FL
Other
Enumeration date
06/02/2015
Last updated
08/02/2021
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