Individual
MR. RANDALL EUGENE LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
30 E APPLE ST, SUITE 5250, DAYTON, OH 45409-2939
(937) 208-7723
(937) 208-3855
Mailing address
30 E APPLE ST, SUITE 5250, DAYTON, OH 45409-2939
(937) 208-7723
(937) 208-3855
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
RN268482
OH
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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