Organization
LAKE SPINE CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLIE SEAGO (RCM)
(214) 378-4656
Entity
Organization
Contact information
Practice address
353 NEW SHACKLE ISLAND RD, SUITE 141C, HENDERSONVILLE, TN 37075-2379
(214) 378-4656
Mailing address
PO BOX 674074, DALLAS, TX 75267-4074
(214) 378-4656
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
43046
TN
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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