NPI 1003305319

Austin Michael Lake, PTDPT

Practitioner Physical Therapist Greeley, CO

Practice location

Address: 4681 W 20th St Unit 202b, Greeley, CO 80634
Phone: (720) 331-3687
Mailing address: 2212 34th Ave, Greeley, CO 80634-7547

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 14911 (CO)

Other Physical Therapist providers in Colorado →

Registry record

NPI: 1003305319
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2018
Record last updated: 4 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.