NPI 1043624083

Lacey Jo Lake

Practitioner Radiologic Technologist Muscatine, IA

Practice location

Address: 2114 Pinefield St, Muscatine, IA 52761-2553
Phone: (563) 607-2372

Registered specialties

Radiologic Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247100000X Licence 11471 (IA)

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Registry record

NPI: 1043624083
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jun 2014
Record last updated: 18 Jun 2014

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.