Individual
DAJE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 NW 24TH RD, OCALA, FL 34475-4865
(352) 258-7330
Mailing address
2105 NW 24TH RD, OCALA, FL 34475-4865
(352) 509-6359
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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