Individual
JARED R. LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-5248
Mailing address
3340 N CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1911
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
7890667-1205
UT
Other
Enumeration date
07/05/2007
Last updated
12/05/2011
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