Individual
DANIEL J LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
14238 PIERCE PLZ, OMAHA, NE 68144-1037
(402) 943-6937
Mailing address
707 W 29TH AVE APT 4, BELLEVUE, NE 68005-5551
(531) 232-7887
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
157987
NE
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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