Individual
DR. ANDREW EDGAR LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
40031 US HIGHWAY 160, SUITE C, BAYFIELD, CO 81122-8746
(970) 884-1072
(970) 884-1074
Mailing address
PO BOX 1745, BAYFIELD, CO 81122-1745
(970) 884-1072
(970) 884-1074
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1657
NM
111N00000X
Chiropractor
Primary
5818
CO
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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