Individual
ZACHARY EDWARD LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1100 RESERVOIR AVE, CRANSTON, RI 02910-5121
(401) 785-3334
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03748
RI
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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